In providing high quality and compassionate care and treatment services to you and your family, Hackettstown Medical Center and our Health Information Management Department (HIM) are dedicated to maintaining the privacy of your Health information.
Your health record is the physical property of our facility. However, the information contained in your health record belongs to you. Your health record is kept confidential - it will be used only for treatment, payment, health operation, and any reporting that is required by law.
Required Written Authorization for Release:
In general, the use and disclosure of your health information requires your written authorization. Please click below and follow the instructions to fill out an authorization to release your health information:
- Authorization to Disclose Protected Health Information - English
- Authorization to Disclose Protected Health Information - Spanish
A completed and signed authorization cannot be sent by e-mail, it must be mailed or faxed to us at the address or fax number below:
Hackettstown Medical Center
651 Willow Grove Street
Hackettstown, NJ 07840