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To request a copy of your medical records by mail from or for OrthoConnecticut, patients must do so in writing using the form below, available for download.

  • Please allow 5-7 business days to accommate your request.
  • OrthoConnecticut may charge a reasonable fee not to exceed 65 cents a page for copying a patient’s record and will charge the costs of materials for copying x-rays.

FOR THE NORTHERN OFFICES:

  • DANBURY, RIDGEFIELD & SOUTHBURY patients, please return the following release form to Jana Pacific:

  • Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

  • Fax: 203-797-1817

  • Mail: OrthoConnecticut, 2 Riverview Drive Danbury, CT 06810. Attn: Jana Pacific, Medical Records

  • Questions: please call 203‑702‑6666
  • For X-ray images and/or records, please contact our X-ray Department at 203‑702‑6605.

 


  • LITCHFIELD, NEW MILFORD & SHARON patients, please return the following release form to Mary Kunic:

  • Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

  • Fax: 860-350-6291

  • Mail: OrthoConnecticut, 131 Kent Road, New Milford, CT 06776. Attn: Mary Kunic, Medical Records

  • Questions: please call 860-355-8000

FOR THE SOUTHERN OFFICES:

  • Please complete and return the following form(s) as required:
    pdfAuthorization for Release of OrthoConnecticut Medical Records
    pdfAuthorization for Release of Medical Records to OrthoConnecticut
  • DARIEN, NORWALK & WESTPORT patients please return above form to Valerie Leone:

    • Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

    • Fax: 203-847-1940

    • Mail: OrthoConnecticut, 761 Main Ave., Suite 115, Norwalk, CT 06851. Attn: Valerie, Medical Records

    • Questions: please email This email address is being protected from spambots. You need JavaScript enabled to view it.