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Medical Records

Medical records request

To request copies of medical records, please download, print and complete the authorization form for the release of protected health information (PHI).  You may send your completed form to our Medical Records Department via mail, fax or secure email.

Medical Records Department
1526 Walden Ave., Suite 850
Cheektowaga, NY 14225
TEL: (716) 895-6700, Ext. 4999
FAX: (716) 332-4488
Notice: If you do not have encrypted and secure email do not send any sensitive or personal information via email.