Routine requests for medical records are generally processed within 10 business days.
IMPORTANT: E-SIGNATURE REQUIRED
This form requires an e-signature to be valid. Please open the below PDF in Adobe Acrobat or another app that allows you to enter information on PDFs (there are many free versions online) to e-sign the document.
Ways to Submit Authorization Request
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Email completed form to [email protected]
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Fax completed form to 212-851-9357
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Mail:
ATTN: Columbia Health Medical Records
Wallach Hall, Suite 125, Mail Code 4202
1116 Amsterdam Avenue
New York, NY 10027
