Request Medical Records
Monmouth Medical Center Southern Campus (MMCSC) is committed to respecting and protecting the rights of patients and families. Our staff is here to ensure the confidentiality of all patients' records by offering you the following options for safely and securely requesting your medical records.
Three Ways to Request Your Medical Records
1. Visit the Patient Portal
Access standard information (last visit notes, medical history, medication, radiology and lab results) in your medical records through our patient portal.
2. Submit an Online Request Form
For standard records as well as records not available through the patient portal, use the fast and secure online electronic Patient Request app hosted by our release-of-information partner, Ciox.
You may choose to have your records delivered electronically, in which case you will get an email with a link to download a PDF, or by mail.
You should receive an email acknowledgement of your online request immediately. You may choose to have records mailed to yourself or to others (for example, doctors' offices).
Most requests will be processed within 3 to 5 business days. Some requests for records that may be in storage or off-site locations may take up to 30 days. Allow 3 additional days for mail delivery.
3. Submit a Paper Request Form
Print out a paper medical record release form (English and Spanish):
- Authorization to Use and Disclose Health Information Form — English
- Autorizacion para la Divulgacion de Informacion Protegida Sobre la Salud — En Español
Complete and return any of the following ways:
- Visit the Ciox Release of Information area located in MMCSC's Main Floor - Administration Hallway
- After hours/weekends: drop the release form in the drop box at the Ciox Release of Information area located in MMCSC’s Main Floor - Administration Hallway
- Fax it to: 732-942-5605
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Mail it to:
Attn: Health Information Management
Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood , NJ 08701
732-363-1900 Ext: 22181
You may choose to have your records delivered electronically, in which case you will get an email with a link to download a PDF, or by mail.
You may choose to have records mailed to yourself or to others (for example, doctors' offices).
Most requests will be processed within 3 to 5 business days. Some requests for records that may be in storage or off-site locations may take up to 30 days. Allow 3 additional days for mail delivery.