FORMS
At Holyoke Health Center, Inc., we respect your privacy. If you would like us to forward a copy of your medical record to a healthcare provider, we need your written authorization along with a legible copy of your valid photo ID and this is done at no cost to you. You may inspect your records or have copies made for a reasonable fee after signing an authorization. If you pick up your medical record in person, you will be required to show a valid photo ID.
To request copies of your medical record, download and fill out the Authorization to Release Medical Record and fax to 413-420-2280. You can also bring in or mail the completed form to:
HOLYOKE HEALTH CENTER
ATTN: HEALTH INFORMATION
230 MAPLE STREET
HOLYOKE, MA 01040
When completing the authorization, please provide the date of service and the information you need, for example: Last Physical Exam, Most Recent Labs or All Records. We are required by law to have written permission prior to releasing certain information. Please initial all sections of the authorization regarding information you want included in your request for records. If you choose not to initial such information then we will exclude that information from your copies.
Authorization to Release Records
The Holyoke Health Center uses MyChart which does have some components of your medical information available for your review If you have not enrolled, you can do so here:
Want to become a Holyoke Health Center, Inc. patient? Complete our new patient registration form.
English 
Spanish