Medical Records Release
Effective January 18, 2018, Ellis Medicine has partnered with Verisma to process medical record requests. Verisma, a proven leader in the industry of Release of Information technology, will securely and confidentially manage patient medical records requests on behalf of Ellis Medicine.
Ellis Medicine protects the use and confidentiality of your medical record. By completing the forms below with your signature, you can securely access your medical record and your request will be processed.
Steps to Release Your Medical Records
Download the following forms:
Authorization for Release of Information
Patient Request for Access to Health Information
Complete forms with your signature
Send completed forms to:
Attn: Health Information Services
Mail Code: 1768
1101 Nott Street
Schenectady, NY 12308