Provided below are various forms that require completion prior to records being sent out or received. Please download the appropriate forms as directed by the physician, and/or staff, by clicking on the name of the form.
* The practice reserves the right to charge seventy-five cents ($0.75) per page for the copying services necessary to complete the request, as well as any applicable mailing fees.
* Please understand that preparation and finalization of the medical records will take a minimum of 7-14 days.
- For copies of X-RAY’S / MRI’S, dated before 05-01-2010 (SVCMC) kindly contact IRONMOUNTAIN @ (800) 394-4627 EXT 331
- For copies of X-RAY’S / MRI’S, dated after 05-01-2010 (NYDH) kindly contact the Department of Radiology @ (212) 312-5654
- NY STATE – HIPPA form – To have medical records from another facility available for your selected / preferred New York Downtown Orthopaedic Associates physician or the New York Downtown Hand Center physician, or to have medical records from New York Downtown Orthopaedic Associates or the New York Downtown Hand Center sent out and/or received by another medical/legal entity – use this form.
- NYD Orthopaedics form – To request medical records processed for personal patient use.
- NYD Hand Center form – To request medical records processed for personal patient use.
After you have completed the necessary form/s, please return it to Lauren Cipriano at
Mail: NEW YORK DOWNTOWN ORTHOPAEDIC ASSOCIATES
170 William Street 8th Floor
New York, NY 10038