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Important Alerts
Office and Urgent Care Closures

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

The Croton-on-Hudson lab and the Patterson lab are temporarily closed until April 30, 2024.

Updates

To make an appointment with former CareMount Women’s Health, please call the office directly. Online scheduling has been temporarily suspended.

Coming soon: Optum Medical Care, P.C. (formerly CareMount) will be upgrading our billing system to ensure that you have a simple, clear and convenient payment experience. Download our Frequently Asked Questions document for more information.

Effective Tuesday, February 20, 2024, changes have been made to the New York flu clinic hours and locations. Please check the webpage for the most up-to-date information.  

Recording/Photography Not Permitted on Premises

COVID-19 Information and Updates

The new COVID-19 vaccine is available at our clinics.

Please note available supply below:

– Supply is limited as we receive weekly deliveries.
– Moderna is available for children and adults (ages 6 months and up)

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Home ❯ Helpful Resources ❯ Medical records request forms – New York

Medical records request forms – New York

Patients can view their Protected Health Information (PHI) through the MyChart patient portal. If the information isn’t available in MyChart, patients can submit a request for their records online using the Patient Medical Records Request Tool. Printable Release of Information (ROI) forms are also available in English and Spanish for patients who do not wish to make use of the online options.

Request records online

Release of Information (ROI) forms

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 (patient), you can complete the Release of Information form.

If you are not the patient, but an authorized representative by law, you will need to provide supporting documentation showing this, when submitting the completed form.

Optum may impose a reasonable, cost-based fee for a copy of your PHI, as permitted by the HIPAA Privacy Rule and state law.

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

  • Email: [email protected]
    Email is not a secure method of communication and carries some risk of being read by a third party. Be advised, that all outbound electronic transmission of medical records are performed via secure transmit
  • Fax: 1-516-812-4305
  • Mail: Optum Medical Care, New York (FKA ProHEALTH)
    Health Information Management Department
    3 Delaware Drive, Suite 206
    Lake Success, NY 11042