Request Your Records
All information contained in the Silver Hill Hospital medical record is confidential and protected by Federal Law under the Health Insurance Portability and Accountability Act (HIPAA).
An original properly completed HIPAA authorization form is required prior to the release of any information (exceptions per HIPAA regulation).
All authorizations must be signed by the patient or legal representative.
Requirements to sign an authorization for release of medical records:
Patient - must be competent and of legal age of 16 or older
Minor patients - signed authorization by legal guardian or custodial parent
Deceased patients - signed authorization by Executor of the Estate with copy of court papers granting conservatorship
Conservator - signed authorization by conservator with copy of court papers granting conservatorship
No charge for copies of 15 pages or less, 16 pages or more are $.65 per page
No charge for copies sent directly to physicians, hospitals, therapists or social service agencies
All requests for medical record information are completed by the Health Information Management Department (HIM).
Silver Hill Hospital
208 Valley Road
New Canaan, CT 06840