To request a copy of your medical records, please complete the Authorization for Release of Information Form.
Complete the form and fax or mail it 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
Fax: (212) 353-5782
There is a charge of $ .75 per page if the 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 seven year period for retention of medical records for an adult patient, and to age 21 for minors.
Authorization Forms
- Authorization for Release of Information Form
- Authorization for Release of Information Form (Spanish)
- Authorization for Release of Information Form (Russian)
- Authorization for Release of Information Form (Chinese)
