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HIPAA -Protected Health Information

Release of Information Form 

A Release of Information form must be signed by you as the patient or your legal representative prior to any release of your medical information not otherwise required by law.  You can download a copy of the form, complete it, sign it and either bring it in to Beverly, Addison Gilbert, BayRidge hospitals or the Beverly Hospital at Danvers.  You may also mail it to

Beverly Hospital
Health Information Management Department
85 Herrick Street
Beverly, MA   01915 

For actual pick up of records, here are the addresses of our departments where release of information takes place:

Addison Gilbert Hospital
Health Information/Medical Records
298 Washington Street
Gloucester, MA 01930

Beverly Hospital Hunt Center
Health Information/Medical Records
75 Lindall Street
Danvers, MA 01923

Beverly Hospital
Health Information/Medical Records
133 Brimbal Avenue
Beverly, MA  01915

BayRidge Hospital
Health Information/Medical Records
60 Granite Street
Lynn, MA 01904