Looking to obtain a copy of your medical records?

Portsmouth Regional Hospital utilizes Ciox Health for release of information. You may request the release of your medical records by printing and completing the following form:

Download Forms

Medical Records Release


Records Sent to Your Home

Upon completion, mail the completed form to:


PO Box 290789
Nashville, TN 37229-0789

Please allow seven to 10 days for Ciox, the firm who handles these requests to process.

For additional information, or to check on a status of a previous request please call (844) 481-0278 .

If you need translation services, please contact the facility Health Information Management (HIM) Department at: 603-433-4044, Option 2.

Records Sent to a Doctor


Fax the completed form to (844) 481-0298

Physician Requests

Ask your doctor for a records release form or have the doctor's office download and print the form for you to complete and sign. Requests that come directly from physicians' offices for medical records will be expedited as needed. There's no charge for records faxed to a physician.