Request Medical Records

Patients and families may request copies of medical records, evaluation reports, and other clinical documents from the Child Mind Institute using the secure form below.

Once your request is submitted, our Medical Records team will review it for completeness and may reach out if additional documentation is needed. Requests are processed in accordance with clinical and legal requirements, and records will be delivered using your selected method once complete.

Medical records requests are typically completed within 10 business days, in accordance with New York and California state requirements. Incomplete requests may result in delays.

You may request records if you are:

• The patient (18 years and older)
• A parent or legal guardian of a patient under 18
• An authorized representative with appropriate legal documentation

To help us process your request as efficiently as possible, please have the following ready:

• A completed Release of Information (ROI) form which is applicable IF:
  • You are the patient or legal guardian(s) requesting that records are sent to another party
  • You are a third-party requesting records on behalf of the patient or legal guardian(s) OR on behalf of the receiving party
• Any required legal documentation (custody agreements, medical decision-making, etc.)

To authorize the release of medical records, you may be required to complete a Release of Information (ROI) form.

Once ready, please submit your request using the secure form below. You will have the option to upload completed documentation directly within the form.

If you have questions about your request or need assistance, please contact Medical Records at [email protected]