Medical Record Request

You can request your medical record at any time by sending a Release of Information (ROI) form to our Medical Records department. All requests must be made by fax or U.S. mail. For your protection, email requests cannot be honored at this time.

To obtain your medical records:

  1. Download and print this form: PDF icon Medical Records ROI Form.pdf
  2. Fill in all required information for processing
  3. Make sure you have signed and dated the form for release of this information
  4. Send your completed form to our Medical Records department by:



SBCHC Medical Records Department
386 West Broadway
South Boston, MA 02127
Phone: (617) 464-7543


SBCHC Medical Records
Fax: (617) 464-7680
Phone: (617) 464-7543

To speak to a member of our internal Medical Records team, please call (617) 464-7540 Monday through Friday, 8:30am - 5:00pm.