Medical Records

Whether you are verifying your medical information or granting access to your medical documentation to another doctor or hospital, our friendly and professional staff at Southwestern Vermont Health Care is available to help you. See the list below for the most common requests. 

To Request Medical Information

Under federal and state law, a patient has the right to request a copy of his or her medical records; however, a completed written authorization is required.  For your convenience, you may download an Authorization for Release of Information here. 

  1. Download an Authorization for Release of Information
  2. Fill it out completely, including the dates of service and when you need the information, to ensure timely processing. 
  3. Fax the completed form to (802) 447-5138. Or mail it to: 

Southwestern Vermont Medical Center
Health Information Services
Attention: Release of Information
100 Hospital Drive
Bennington, VT 05201

If copies are going directly to a physician or hospital, there is no charge. If 10 or more pages of your medical record are being directed to you or to another party, a charge of $0.50 per page applies. You will be invoiced for this service. 

Questions may be directed to (802) 447-5323.

To Request X-Ray or other Images

You may request a copy of your CT Scan, MRI, X-ray, or other images by contacting the SVMC Health Information Services at (802) 447-5323.  If you need a copy of the radiologist's interpretation of the image please indicate that at the time of the request.

Birth and Death Certificates

If you would like to obtain a copy of a birth or a death certificate, please contact the Bennington Town Clerk's office at (802) 442-1043.

To Request Change to Your Medical Information

To request a change to your medical record:

  1. Download the Health Care Health Record Correction/Amendment form
  2. Fill it out
  3. Keep a copy for yourself and mail the complete form to:
Southwestern Vermont Medical Center
Health Information Services
Attention: Director
100 Hospital Drive
Bennington, VT 05201