Medical Records Request


Spine Institute of New York maintains compliance with HIPAA regulations regarding confidentiality of patient’s medical records. A signed Release of Medical Authorization Form (download now) is required from the patient to obtain copies of medical records. There is a fee associated with the copying of medical records.

Film Requests

A patient may sign out their films. The patient is responsible for the safekeeping and return of the films for any future visits.

Please contact our Medical Records Office at (212) 844-8680 for information and fees associated with the copying of films. Films are sent via Regular Mail unless the patient provides us with a credit card or Federal Express Account number.

Submitting Requests

  1. Download a Medical Information Release Form.
  2. After downloading the form and completing the information, please use the following mailing address or fax number to submit your medical record/film request.
By fax:

(Attention: Medical Records)


Mailing Address:

Spine Institute

Beth Israel Medical Center

10 Union Square East, Suite 5P

New York, NY 10003

Attn: Medical Records Request 

The Spine Institute will make every attempt possible to process medical record/film requests in a timely manner. Some medical record/film requests may be in an off-site storage and may take up to ten business days to process.

Contact Our Office

Beth Israel Medical Center
10 Union Square East | Suite 5P
New York, NY 10003

Phone: (212) 844-8680
Fax: (212) 844-8681

Office Hours

Office Open:
Monday-Friday, 8am-5pm

Telephones are answered:
Monday-Friday, 9am-4pm
*Excluding holidays

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