Records and Forms

Records and Forms

To request an official copy of patient records please complete the appropriate form shown below. Once completed please mail your form to Wilmington Health Medical Records Department at:

Attn: Medical Records
1202 Medical Center Dr.
Wilmington, NC 28401

Please ensure that all information is complete and legible including the patient name, date of birth, and a phone number that can be used to contact the requestor with any questions. Please note, if you are not the patient please indicate your relationship and include documentation of your legal designation such as Custodial paperwork, death certificate, Healthcare Power of Attorney, etc.

Please note that patients will no longer be able to walk up to Medical Records at this time.

For questions please contact our Medical Records department at 910.341.3311 .

Medical Records Request Form

Authorization to Release Medical Records
Pediatric Patients' Authorization to Release Medical Records

Authorization to Release Medical Records (Spanish)
Pediatric Patients' Authorization to Release Medical Records (Spanish)