Forms and Resources

Medical Records Release

If you would like to transfer or obtain a copy of your medical records, you need to fill out this form. 

If you would like to send us a copy of your medical records, you need to fill out this form. 

Mail or fax the completed form to:

1055 Commonwealth Avenue

Boston, MA 02215

fax:  617-616-1617

If you are enrolled in our Patient Portal and would like to request an electronic copy of your medical records  

1. Log in to your patient portal account using your email and password
2. Select "My Health" on the left sidebar.
3. Select "Health Records"
4. Select the Health Records you want to send

• Select Period as either "All Time" "Single Date" "Custom Range Date"
  • If your records are being requested from before 2009, please send us a message through the patient portal with the dates of the requested records or fill out a medical records request form (https://www.plannedparenthood.org/planned-parenthood-massachusetts/online-health-center/forms-and-resources)
  • Select the type of records you would like to send
    • Consolidated Clinical Summary (CCDA) includes your complete health history (xml and pdf version)
    • Encounter Clinical Summary (CCD) includes your Continuity of Care information provides a more succinct version of your healthcare history and documents for continuing care (xml version)
    • Referral Notes is a document created when a provider refers a patient outside of PPLM (xml version)
  • Choose where you would like to send your information
    • Download: will download your requested records to your computer directly
    • Send via Direct Address: emails your records to a direct address. 
      • If your external provider has given you a direct access email (ends in @direct), you can input it directly 
      • If you are unsure if your external provider has a direct access email, please contact your provider for more information
    • Send via Email: emails your records to a non-secure/non-direct email address of your choice
      • Please note: this is a standard, unencrypted email. If you would like to send it securely and confidentially, see "Send via Direct Address"

If you have any questions about accessing your medical records, please contact us through your portal account or give us a call at 1-800-258-4448 Opt.2 .