medical records

TO OBTAIN A COPY OF YOUR MEDICAL RECORDS:

1. Complete an Authorization to Use or Disclose Health Information. Be sure to complete all information requested and clearly state the dates of service or types of reports needed.

   You may download the authorization from this website or come in to the Health Information Mangement Department (Medical Records) to complete the form.

   Hours of Operation:
   Monday to Friday 7:00 AM until 7:00 PM
   Saturday/Sunday 8:00 AM until 4:30 PM

2. Sign and date the authorization. The authorization must be signed by the patient or legally authorized representative. For deceased patients, the request for records must be accompanied by a Letter of Testamentary or Short Certificate so that we can verify the patient’s legal representative. This form may be obtained by contacting the Gloucester County Surrogates Office at (856) 853-3282.
3. Submit your completed authorization to the Medical Records Department at the following address:

   Underwood-Memorial Hospital
   509 N. Broad Street
   Woodbury, NJ 08096
   ATTN: Health Information Management Department

Records requested for continuing care purposes will be sent directly to your physician or other healthcare facility. If you have a follow-up appointment, please be sure to include the date of your appointment on your request. An abstract of your record containing all pertinent parts of the chart including doctors reports, laboratory, radiology, and other diagnostic test results will be faxed or mailed your health care provider at no charge.

All other requests for copies of the medical record are usually processed within 10 working days. (Some requests may take as long as 30 days to process). There are fees associated with photocopying medical records that are set in accordance with New Jersey State law. We will let you know how much the total charge will be once we retrieve your records. Upon receipt of your payment, the requested information will be forwarded.

If you have any other questions or need futher information, please feel free to contact our Health Information Management Department at (856) 853-2021.

FOR RADIOLOGY FILMS:

Please contact the Radiology Department at (856) 853-2040

FOR COPIES OF HOSPITAL BILLS:

Please contact the Patient Accounts Department at (856) 845-0100 Ext. 2200

FOR COPIES OF BIRTH CERTIFICATES OR DEATH CERTIFICATES:

Please contact the Gloucester County Office of Vital Statistics at (856) 845-1300. Birth and death certificates are not issued by Underwood-Memorial Hospital