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Office and Urgent Care Closures

Cardiology-Jersey City is temporarily closed, while Cardiology-Newark is closed permanently.

The Croton-on-Hudson lab is temporarily closed until further notice.

As of November 20,  the Urgent Care in Carmel,  has moved to 100 Independent Way, Brewster NY.

Updates

Effective December 12, 2024, Dr. Pierce will no longer be practicing obstetrics & gynecology out of 1985 Crompond Road, building B. She will continue to see patients at Jefferson Valley and Yorktown Heights only.

As of December 20, 2024, Dr. Weinfeld will no longer be practicing podiatry out of 48 US 6 in Yorktown Heights and he will be re-locating full time to Jefferson Valley.

As of December 12, 2024, Dr. Fijman will no longer be practicing pulmonology and sleep medicine out of 310 North Highland Avenue, Suite 4 in Ossining and he will be re-locating full time to Jefferson Valley.

As of November 18,  Stacey Radinsky, MD has moved her practice to Bethpage.

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Home ❯ Helpful Resources ❯ Access Medical Records. New Jersey (Riverside)

Access Medical Records. New Jersey (Riverside)

Patient Record Release Form

Please download the request for access form and follow the guidelines for completion.

(Get a Copy of Your Healthcare Information (Records))

Complete this form to request a copy of protected health information (PHI) maintained and used to make decisions about your treatment, including mental/behavioral health records that are maintained as part of your care by Riverside Medical Group a Part of Optum. Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), this is called the Designated Record Set (DRS). Please complete each section of the form. Forms submitted with incomplete or unreadable information, insufficient legal authority, or signed by the incorrect individual may result in processing delays. If you are using this form for another individual, follow the guideline as below. Optum may impose a reasonable, cost-based fee for a copy of your PHI, as permitted by the HIPAA Privacy Rule and state law.

If you are requesting Access to Another Individual’s Records

Please have the patient sign the Authorization to Release Information Form
 Authorization to Release Information form (English)
 Authorization to Release Information form (Español)

Submit the completed form with your request if:

  1. You are not the legal representative, OR
  2. The patient is 12 or older, and the records may relate to sensitive health information, such as mental health, substance use, HIV/AIDs, STD, pregnancy, or reproductive health.
  3. If you qualify as a legal representative, you are required to attach supporting documentation:
  • Power of attorney, Court Order, or another valid document
  • HIPAA authorizations do not establish legal authority and are not sufficient to submit an access request through this process

Return the completed form using one of the options listed below:

Mail: Optum Medical Care of New Jersey (FKA Riverside Medical Group) HIM Department, 3 Delaware Drive, Suite 206, Lake Success, NY 11042