Medical Records

How To Request Your Medical Records

Medical records may include items such as your health history, test results, office visit documentation, discharge summaries, and records of procedures or treatments.If you would like copies of your records, please contact our office and we will provide records related to care you received here.

To request medical records from Towerlight Health and Wellness, please complete our Authorization for Release of Medical Information form, or send a signed letter that includes:
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  • Your full name
  • Your address
  • Your date of birth
  • Your telephone number
  • The purpose of the request
  • The specific records you are requesting
  • Where the records should be sent
  • Your signature



With ALL required information included, please fax or mail your request to:

Release of Information

Fax:
fax number


Mailing Address:

Towerlight Health and Wellness 
Medical Records
13 Steeple St., ste 202-37
Mashpee, MA 02649

Do not e-mail this release of information request. Towerlight Health and Wellness cannot guarantee security of all Personally Identifiable Information included in the request form if it is submitted via e-mail.

Fees

If you request a copy of your medical record from Towerlight Health and Wellness, we may charge a reasonable, cost based fee for copying and mailing records, as permitted by HIPAA (45 C.F.R. § 164.524). Fees vary based on the size of the request and the method of delivery. Any fees charged will not exceed applicable Massachusetts law (M.G.L. c. 111, § 70).