Medical Records Information
If you wish to obtain a copy of a Birth Certificate, please call the Concord Town Clerk’s Office at 978.318.3080. Or you can write the Town Clerk at: Concord Town Clerk, PO Box 535, Concord, MA 01742. The website is www.concordma.gov; or you can send an e-mail to email@example.com
The clerk will be able to provide you with a certified copy of the Birth Certificate. A fee for this service may be charged. Paternity papers may also be completed post birth at the Town Clerk's Office as well.
The Medical Records Department has on-site access to most records for the past 3 years. Older records are available, but will take longer to retrieve. Massachusetts law requires that we maintain hospital records for 20 years following your last visit. Records available include laboratory reports, radiology reports, emergency department visits, outpatient surgeries, and inpatient stays at Emerson Hospital. The Medical Records Department does not have access to individual physician office records.
If you have been a patient at Emerson Hospital, you may obtain a copy of your record through the Medical Record Department, Release of Information Section (ROI) located on the 3rd floor of the East Building. You will need to sign an Emerson Hospital Authorization to Release PHI Form and provide us with a drivers license or other photo ID for verification.
As an alternative you can print out the form at the link below and fax it to 978-287-3652, or mail it to the address at the top of the form. The authorization form must be filled out completely, including the patient’s date of birth, dates of service being requested, what the records are being obtained for, i.e., personal, physician visit, legal, etc. Please include the phone number for the patient as well as complete mailing address and phone number for where the records are being sent.
Please allow 7-10 business days for a standard request to be completed. A fee may be charged for copies of your medical record. If you need to speak to a ROI Coordinator, please call 978-287-1138 or e-mail ROI@emersonhosp.org
Download Authorization to Use and Disclose Protected Health Information Form
Request for Correction/Amendment of Protected Health Information
The HIPAA Privacy Rule grants patients the right to request an amendment to information in their medical records; however, it does not require the author of the information to grant the request if any of the following criteria is met:
1. The information was not created by Emerson Hospital
2. The information is not part of the official medical record (Designated Record Set)
3. The information is accurate and complete
As the medical record is a legal document, entries cannot be removed from it once made; however, if your request for amendment is accepted a statement will be made within your medical record reflecting the change.
If you wish to request an amendment to your medical record, please download the form, complete it in its entirety, sign, date and return it to the Privacy Officer, Emerson Hospital Medical Record Department, 133 ORNAC, Concord, MA 01742. If you have any questions, please call 978.287.3995.
Request for Correction/Amendment of Protected Health Information Form