Medical Records
Mountainside Medical Center and Mountainside Medical Group offer the following individuals the ability to request electronic medical records easily online through the MyChart patient portal or our online request platform:
- Patients requesting their own records
- Parents of minor patients requesting records
- Caregivers acting on behalf of a patient (i.e. Power of Attorney)
Request Records in MyChart
View your patient medical record securely from your computer or mobile device through MyChart. Once logged in to MyChart, go to Menu > Document Center > Requested Records > Click to send a request for records and complete the form. Click below to sign in.
Request Records in MyChart
(patient or legal guardian with MyChart accounts)
Request Records Online
Receive a copy of your medical record request using our online request platform. To verify your identity, you will need to submit a photo of your driver’s license. Click below to begin the request. A copy of your record will be sent to the email address provided.
Request Records Online
(patient or representative requests only)
Request Records on Paper*
To request your medical request on paper, click the appropriate link below to download the form.
Once complete, submit the paper form in one of two ways:
- Fax: 973-680-7910
-
Mail or in-person delivery:
Health Information Management
Mountainside Medical Center
1 Bay Avenue
Montclair, NJ 07042
*Please note there may be a fee associated with processing a paper request.
A HIPAA-compliant request for records must contain the following information:
- A description of the information that will be used/disclosed. It is important to indicate what records are needed as well as a date range. This will expedite the request.
- The purpose for which the information will be disclosed.
- The name of the person or entity to whom the information will be disclosed.
- A signature and date that the authorization is signed by an individual or an individual’s representative. If a representative is signing the form, the relationship with the patient must be detailed along with a description of the representative’s authority to act on behalf of the patient.
For questions about your medical records:
Email: medicalrecordsahs@cioxhealth.com or 64495_HACKENSACK_MERIDIAN_MOUNTAINSIDE@cioxhealth.com
OR
Fax: 470-589-2670
Frequently Asked Questions
All requests for release of information must be made in writing. For assistance with this process, call Health Information Management at 973-429-6042.
A hospital release of information form can be used, or you can write a letter with all of the appropriate information. Faxes are accepted for patient requests. E-mails and/or telephone/verbal requests are not accepted.
Inpatients must complete a release of information form to receive copies of medical records, to read their records, and to allow others to read the record. Release of Information forms are available in the Health Information Management Department.
Usually, records are mailed by our copy service to the location you request. Some records may be available for pick-up.
Health Information Management Department
Mountainside Medical Center
1 Bay Ave.
Montclair, NJ 07042
Hours: Mon. - Fri. 8:30 a.m. to 4:30 p.m.
A 30-day time period is allowed to produce requested medical records (NJAC8:43G-15.3). However, it generally takes 7-10 days.
For copies of medical records that are sent directly to a physician or medical professional's office for patient care, there is NO fee. There will be a charge of $1 per page for copies made for any other reason (NJAC8:43G-15.3(d)1.). We recommend getting an abstract (key reports and lab results) to minimize the cost.
Payment can be made by check or credit card.
For more information about payment call 973-429-6042, 8:30 a.m. to 4:30 p.m. Monday - Friday.
If you cannot afford to pay, you can still obtain your medical records. Contact the Health Information Management Department for details at 973-429-6042.
New Jersey hospital licensure standards (NJAC8:43G-15.3(d)1.) allow health care facilities to charge a fee for copying records You are charged this fee based on the costs of materials and staff time spent copying your records. You will not be charged for time spent searching for your records.
Only the patient or the patient’s guardian or other legally authorized individual can obtain records or direct their release.
Health Information Management
Mountainside Medical Center
1 Bay Avenue
Montclair, NJ 07042
Fax: 973-680-7910
You must fill out a Release of Information form. Health Information management will release your records per your request.
If you were born at Mountainside Medical Center, your birth was filed through the registrar in Glen Ridge, NJ. To obtain a copy of your birth certificate, please contact the Glen Ridge Bureau of Vital Statistics at (973) 748-8400, ext. 221.
To obtain a copy of a death certificate, you must contact the Vital Statistics Office for the state of New Jersey (or state in which the deceased expired). The Vital Statistics Office can be reached through: www.state.nj.us/nj/community/statistic. The following link contains additional instructions on obtaining death records: www.vitalrec.com/nj.html. With the instructions from this website, death records can be requested through the mail or electronically. The phone for the NJ Bureau of Vital Statistics and Registration is 609-292-4087.
To obtain x-rays and/or films, contact Health Information Management at 973-429-6042 and we will assist you.
If you have additional questions, contact Health Information Management at 973-429-6042.
Medical Records
For more billing information or to pay your bill please call (866) 525-5558.
Hackensack Meridian
Mountainside Medical Center
One Bay Avenue
Montclair, NJ 07042
Call us: (973) 429-6000