Medical Records

If you identify that information in your medical record is incorrect, please submit a completed form to amend health information. Include your current address and phone number. 

Patient Request to Amend Health Information (PDF)

Fax or mail form to:

The Summit

100 Reserve Road

Danbury, CT 06810

Attn: Health Information Management

Fax: (203) 749-9000

If copies of your records are going directly to a physician or hospital, there is no charge. If copies are being sent directly to you, there is a fee of 12 cents per page. An additional form is required to obtain records for a deceased patient. Please find additional forms below:

• Affidavit of Distributee
• Health Care Proxy/Surrogate Certification