Obtaining Medical Records from LRH
You have the right to inspect and receive a copy of your medical information. This includes medical and billing records. We may deny your request to inspect your records in certain very limited circumstances, but you always have a right to a copy of the records. Your request to inspect or receive a copy of your medical information kept by LRH must be in writing. By policy and for your protection, we do not disclose medical information to you by phone. For copies of your clinical records kept by your primary care physician, you should contact them directly.
LRH offers 4 convenient ways to submit your request for medical information:
You may mail the Authorization Request directly to:
Health Information Management
Littleton Regional Healthcare
600 St Johnsbury Road
Littleton, NH 03561
Be sure to include your full legal name, date of birth, and social security number to correctly identify your records, as well as your phone number and address in case we should have any questions regarding your request. Please allow up to 30 days for the processing of your request.
Normally it does not take this amount of time to receive your record. However, please understand that your medical record needs to be complete before we can release the information. Providers have 30 days to complete medical recordings.
For a more urgent request, you may submit your request by fax to the HIM Department at 603-259-7559.
3. Authorization Forms
- How to Fill Out a Release of Information (PDF)
- Authorization For Release Of Information (PDF)
- Permission of LRH to Discuss Treatment Information (PDF)
- Affidavit of Surviving Spouse or Next of Kin Seeking Access to Medical Records (PDF)
IMPORTANT: Please include your phone contact information so we may call and verify your request for information. This is for your protection so that no one else requests your personal medical information.
4. In Person
You may stop by the Health Information Management Department in person at Littleton Regional Healthcare in the main lobby, during the hours of 7:30 AM to 4:00 PM, Monday through Friday except for holidays, and complete the authorization form. Due to the number of requests received, we normally mail your medical information directly to you within 30 working days. In some cases, we may process your request on the spot. Again, normally it does not take 30 days, however, please understand your medical record needs to be complete before we can release the information. Providers have 30 days.
Notice For Patients
You may request your medical records to be delivered by what is called E-Delivery. You still need to complete an Authorization to Release Medical Records form. When requesting your medical records electronically, you can request this be completed within 72 hours from the time you turn in your Authorization to Release Medical Records form. You must request this service otherwise your request will be processed within our normal time frame of 2 weeks (10 working days).
Birth Certificate Information
Obtaining Certified Copies of Birth Certificate
When a baby is born at Littleton Regional Healthcare, we have the parent(s) complete what is called Mother’s Worksheet for Child Birth Certificate. This worksheet provides us with the information to complete the process for a birth certificate.
New parents will receive the Parent Notice in the mail from Health Information Management. Please examine this information very carefully to be sure it is correct in every detail, especially that the names are spelled and all dates are correct. If you find an error, please contact Health Information Management at 603-444-9538 or the Littleton Town Clerk’s Office at 603-444-3996 Ext. 23, for any corrections. For parents residing in New Hampshire, the Parent Notice can be taken to your Town Clerk’s office to obtain a Birth Certificate. Parents residing in a different state should take the Parent Notice to any New Hampshire Town Clerk’s Office to obtain a Birth Certificate.
Looking for a Copy of Your Birth Certificate?
If you are looking to obtain Certified Copies of Birth Certificates for children that were born at Littleton Regional Healthcare, you can:
- Go to the Littleton Town Clerk’s office. Be sure to bring current photo identification
- Visit New Hampshire Vital Records online to complete a Certificate Application
- Call Vital Records at 603-271-4650.
Every person is encouraged to maintain a personal health record (PHR). These are beneficial when seeing a new physician and especially helpful if you are caring for another individual (parent, child).
A PHR can be a matter of life and death should a major disaster hit our area and destroy the buildings (physician offices, hospitals, laboratories, etc.) that currently house records of your care (e.g. Katrina).
Your PHR should contain important information about you and your health care such as:
- Identification Information: Insurance numbers, your name (including maiden name), date of birth, social security number, address, telephone number, employer name, contact and telephone number, dentist name, and telephone number, and any physical identification marks and/or some hair samples.
- Problem List: Conditions you have been treated for in the past and currently and any surgeries.
- Medication List: Name of medication, dosage, prescribing physician, pharmacy holding your prescription.
- Results of Significant Tests: X-ray reports, laboratory results, pathology results, colonoscopies, etc.
- History: List of hospitals, physicians, and dentists who may have health information about you.
- Special Documents: Power of Attorney, Healthcare Proxy, and/or Advance Directive.