Please click on the link below to request your records directly online. You will need a copy of valid ID to import within your request and/or legal documents if requesting on behalf of a patient. This request is completed by CIOX Health on behalf of AtlantiCare. If you have any questions in regard to your request, please call 866-771-5162.
Completing the Authorization Request form begins the record request process.
Used when an individual requests a copy of his/her own medical record; or to send the record to a third party
Used when an individual requests a change and/or preferences to their PHI.
Used when an individual requests that we release information to a third party and it contains sensitive data (mental health, substance use or HIV/AIDS). This form contains a provisions that prohibits re-disclosure by the recipient
Request must be signed by the person who the records belong to, or by a LEGALLY authorized person.
Records will be mailed to a physician or other healthcare facility for free. Please provide the telephone number or address so they can be sent promptly.
If you are requesting your records and they are not being mailed by us to a physician or healthcare facility there is a $00.15 per page charge (up to 100 pages & $0.25 per page after that) please keep this charge in mind when requesting a complete chart, as this can get very expensive. A discharge summary often gives a satisfactory overview of the course of the hospital stay that is longer than 72 hours, stays less then 72 hours discharge instruction will be available.
AtlantiCare Regional Medical Center-City Campus
1925 Pacific Avenue
Atlantic City, NJ 08401
Attn: Health Information Mgmt.
When your records have been processed, an invoice will be mailed to you and when payment has been submitted, the records will be sent out by mail.
OR Please email your completed request to HIMROI@atlanticare.org
If you have any questions please feel free to call the Release of Information/HIM Department.
ARMC City: 609-441-8987
Hours: 8:00 am to 4:00 pm Monday-Friday
