Medical Records

Complete a Medical Record Authorization Form: English | Haitian Creole | Portuguese | Spanish
Then, send it to us:

Fax to CHA Health Information Management: 617-381-7179
Mail to CHA Medical Records - 103 Garland Street Everett, MA 02149
Email us at HIM3@CHAlliance.org a scan of your hand-signed form as a PDF file
Please note, we no longer offer walk-in services

There may be a cost for copies:

If you want copies, we will charge a reasonable fee for them. We also charge postage costs, if you want us to mail the copies to you.

Patients can request 5 years worth of their medical records via MyChart.

If you are 18 and older or a parent/guardian please follow the below once logging into MyChart:

Select: Your Menu
Scroll down and select: Sharing Hub
Scroll down to the bottom of the page select: Request formal copy of Health Record.
Fill in the form to request your records
Once you press complete you will be taken to a consent page. Select: I Agree and Send request
Patients will receive a MyChart notification that their records are ready and can retrieve them from: Your Menu ~ Document Center ~ Requested Records

Have Questions? Call us directly at 617-381-7126

If you would like to amend your medical record due to incomplete or inaccurate information, please use the following form:

Request an Amendment of Protected Health Information:

Please send the completed form to this address:

Cambridge Health Alliance Privacy Office

103 Garland St.

Everett, MA 02149

As a CHA patient, you can ask us to not share your medical records with other providers. Simply complete our opt out form and return it to us.

Opt out of Medical Information Sharing:

English

Please send the completed form to:

Mail: CHA Everett Hospital Health Information Management
103 Garland Street
Everett, MA 02149

Fax: 617-381-7277

Email: HIM2@challiance.org