Patient Medical Records
Requesting Your Medical Records
Medical records are documentation of a patient’s key clinical data and medical history. This includes diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results. Having a complete and accurate medical record is important for health care clinicians and patients alike.
Patients treated at Fair Haven Community Health Care can request a copy of their medical records. If you will like a copy of your medical record, please complete our Authorization for Access/Release of Information form:
- To fill out your form online, click here for English and here for Spanish.
- To download a form, click here for English or click here for Spanish. If downloading, please return this completed form to any of our locations during normal business hours or email it to firstname.lastname@example.org.
Please allow up to four weeks for a response.
For Official Immunization Records
Get your immunization record through the secure CT WiZ Public Portal, a free service provided by the Connecticut Department of Public Health Immunization Program. Patients and legal guardians can access official immunization records for themselves and their children as well. All you need to provide is first name and last name, as they appear in your clinical records where you received the vaccine and your birth date.
CT WiZ is the statewide Immunization Information System (IIS) designed to meet national standard requirements for effective tracking and administration of immunizations in a public health setting. It is a web-based database that maintains complete, accurate, and secure immunization records for all patients vaccinated in Connecticut. All personal information including immunization status and dates of immunization of individuals shall be confidential as required by Connecticut law.