For Patients: In accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and Connecticut law, you have a right to your health information.

You can retrieve your clinical visit summary via the ONS Patient Portal. To obtain copies of X-ray or MRI images, or any other documents, complete the form below. Requests for images will be processed by ONS staff, who will send your images by secure email or will copy onto a CD and send by US mail for a minimal fee.

Please note, records will not be released without the medical records request and authorization form (below).

Charges: You will not be charged for records accessed via the patient portal. For all other requests, payment is required prior to releasing your record copies. An email invoice will be sent if your email address has been provided.

The following fees are based on State & Federal regulated rates:
CT State-regulated rates: $0.65/page (maximum charge $6.50)
No fee for requests sent directly to a physician’s office or healthcare facility for continuing care.

You may download your clinical visit summary (no images) at no charge through the ONS Patient Portal. Login to your Patient Portal account and click the Health Records icon.

MRI/X-ray images may be sent to you electronically via a HIPAA secure link – fee is $15

Alternatively, MRI/X-ray images may copies to a CD and sent by US mail- fee is $25

Third Party Record Requests
For Records Requests by a third party, click here.

Legal Requests for Medical Records
For questions related to a legal request, please contact DMRS at 800-359-8520, between 10:00 AM and 6:30 PM, Monday-Friday. You may also email your question to questions@dmrs.net.

API information
ONS supports patients’ access to their health information. Beyond the Patient Portal, we also support sharing health information via apps that use an Application Programming Interface (API), used by many mobile device apps. We have enabled the necessary solutions to receive requests from API applications, however, to date, there are no apps available that can connect to our data. When we become aware of any applications that our patients can begin to use, we will share the information with you.

Please be sure to scroll to the very bottom of the form after you have submitted your request to make sure there were no errors with your submission.

Thank you!

Request Medical Records Form

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  • Please select one or more records you would like to request.

    Please note: MRI reports are available through the Patient Portal. We are now able to send images electronically through a HIPAA secure process. Electronic copies of images can be sent to another Physician’s office, or copied onto a disc and sent to you by mail.
  • MM slash DD slash YYYY
    Please specify approximate range of dates of appointment(s):
  • MM slash DD slash YYYY

  • Copies

    Processing Timeframe • 1 to 5 business days for electronic submission • 3 to 5 business days if send by mail
  • MM slash DD slash YYYY
  • Or fax:

  • Verification

  • MM slash DD slash YYYY
    MM/DD/YYYY
  • Reset signature Signature locked. Reset to sign again

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