Dental Record Request

At Touro Dental Health, we are dedicated to maintaining a high level of privacy and confidentiality with all patient dental records. We keep all health information private and secure in accordance with federal and state regulations.

A patient, guardian/legal representative, or healthcare provider may request a copy or transfer of the patient’s dental records by submitting the form below via mail, email, fax or in-person. Please allow up to 30 days for requests to be completed.

2022 Release of Information Forms

Fax: 914.594.2681
Mail: Touro Dental Health, Release of Information, 19 Skyline Drive, Hawthorne, NY 10580

For more information, contact Touro Dental Health at 914-594-2700.