Release of Medical Information

To request copies of your medical records, please download and fill out the Authorization to Release form below.

Be sure to complete all blank areas and sign and date on page 2.

Mail to:
Health Information Services
CA Dean Memorial Hospital
PO Box 1129
Greenville, Maine 04441

Fax to: 207-695-2254

Remember…If you want records on any patient; other than yourself, you must contact our department for further instructions on what may be needed.

Please feel free to call us at (207) 695-5225

Sincerely,
Health Information Services