Request Your Patient Information

If you would like a copy of your Patient Information, please complete the following steps:

  1. Click at the bottom of this page to download an Authorization For Release Of Patient Information Form, in either English or Spanish.
  2. Print the downloaded form and complete it in full.
  3. Mail the completed form to the address below.

Medical Records Department
HackensackUMC Palisades
7600 River Road
North Bergen, NJ 07047

If you have additional questions, please contact HackensackUMC Palisades at (201) 854-5081 or (201) 854-5083.

Authorization_For_Release_Of_Patient_InformationAutorizacion_Para_Publicar_La_Informacion_Del_Paciente