New York Eye and Ear Infirmary
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How to Obtain Copies of Your Medical Record

To request a copy of your record, download and print the "Authorization For Release of Information" form below.

Complete the form and fax or mail to the Medical Records department:

New York Eye and Ear Infirmary of Mount Sinai
Medical Records Department
310 East 14th Street
New York, NY 10003
TEL: (212) 979-4352
FAX: (212) 353-5782

There is a charge of $ .75 per page if record is being copied for the patient. If the record is being sent to a doctor, there is no fee.

Please note: New York State law specifies a 7 year period for retention of medical records for an adult patient, and to age 21 for minors.  

Authorization Form


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