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Request Your Record

Patients of CentraState Medical Center have a right to access or request a copy of their medical records.
 
CentraState is concerned about the privacy and security of medical records information and has policies in place to protect patients from unauthorized release of personal health information. These policies are for your protection and are consistent with relevant governmental regulations.
 
Those privacy regulations include the Health Insurance Portability and Privacy Act (HIPAA), which went into effect on April 13, 2003. In our effort to comply with these regulations, we must require that everyone who requests medical records information submit an authorization for copies and/or access to patient medical records using CentraState Medical Center’s "Authorization for Release of Health Information" form.
 
For your convenience, a copy of the form is available to the right in the "Related Documents" box. Please click on the link to download the form, print it out, complete it, and fax, mail or bring it to the Health Information Management Department located on the lower level of the hospital. Our fax number and mailing address also are provided below.
    
Mailing Address:
CentraState Medical Center
901 West Main Street
Freehold, NJ 07728
Attn: Health Information Management Department- ROI

Fax Number: (732) 294-2535
* Please Note: A per-page service charge may apply when requesting a copy of your chart.
    
For More Information
It is our goal to provide you with excellent customer service. If you have any questions regarding release of patient health information, or on completing the required authorization form, please call the Health Information Management Department at (732) 294-2750.