The Health Information Management Department is dedicated to maintaining your medical records and keeping your health information private and secure in accordance with patient’s rights and federal and state regulations. For additional information regarding health records and privacy, please view our Notice of Health Information Privacy Practices.
Health Information Management Department
3073 White Mountain Highway
North Conway, NH 03860
A patient or their legal representative may inspect and/or obtain a copy of their health information, or have copies of their records sent to another facility elsewhere. You may request a copy of your records on paper, on USB flash drive, or on a compact disc (CD).
A completed and signed Authorization to Release Protected Health Information form along with valid identification is required for copies of records to be released. To request the form be faxed or mailed to you, please call 603-356-0646. To pick up a copy of the form, please visit us at the Health Information Management Department at Memorial Hospital, 3073 White Mountain Highway, North Conway, NH 03860.
Please send completed, signed and dated forms to the Health Information Management Department by mail to Memorial Hospital, 3073 White Mountain Highway, North Conway, NH 03860. You may also fax your form to 207-661-8900.
Yes. Please be aware that there may be a “reasonable cost-based fee” for copying protected health information in accordance with the State of New Hampshire Statutes. The exact fee amount will not be determined until the request has been fulfilled, at which time an invoice will be sent. In some cases, fees may be required prior to releasing the records requested. Payment is acceptable by check or credit/debit card.
Memorial Hospital does not maintain birth certificates. Birth certificates can be obtained from the Conway Town Clerk’s office at the Conway Town Office or the New Hampshire Vital Records Department in Concord.
Conway Town Clerk Office: 603-447-3811 ext.218
Memorial Hospital offers online access to your medical records through MyChart. It’s private, free and easy-to-use. MyChart gives you the ability to access your health information at your convenience, through a secure website. MyChart allows you to be actively involved in your health care, the ability to communicate with your providers, and help you stay informed.