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Medical Records & Release Forms

How We May Use & Disclose Medical Information

For Treatment

We may use health information about you to provide you with medical treatment or services. We may release health information about you to doctors, nurses, technicians, students, or other hospital staff who are involved in taking care of you. For additional information regarding health records and privacy, please refer to the Notice of Health Information Privacy Practices.

For Payment

We may use and release health information about you so that the treatment and services you receive at the hospital may be billed and payment may be collected.

For Health Care Operations

We may use and disclose health information about you for hospital actions. These uses and releases are necessary to run the hospital and make sure that all patients receive quality care. Other types of uses and releases of your health information:

  • Individuals involved in your care
  • Treatment Alternatives
  • Worker's Compensation
  • Health Oversight Activities as Required by Law
  • Hospital Directory
  • Clergy Visits

Release of Information

If you would like a copy of your medical record, print and complete the authorization to release medical records and mail or fax it to the address below.

We cannot accept e-mail requests for copies of medical records. The patient’s original signature or authorized representative’s original signature is required. Patients should contact a Release of Information Specialist to determine fees for requested copies.

Birth Certificates

Birth certificates can be obtained from the City Clerk's office at Portland City Hall. The City Clerk can be reached by phone at (207) 874-8610 or by fax at (207) 874-8612.

Contact Us

Health Information Management Correspondence Office
Maine Medical Center
22 Bramhall Street Portland, ME 04102
Phone (207) 662-2211
Fax (207) 761-3092


Maine Medical Center is a member of the MaineHealth System