Student Health Services at The College of New Jersey is committed to upholding the highest standards regarding the confidentiality of health records.
To request a copy of your medical record, download the Authorization for Release of Health Information*[PDF 321k]. Student Health Services retains medical records for 10 years after a student leaves The College of New Jersey.
Please fill this form out completely and be very specific about what you want released. Be sure to sign and date the form to avoid delays in processing your request. Note that this request is only for your records from Student Health Services, not for those from Planned Parenthood or Counseling & Psychological Services (CAPS) (see below for more information).
Email the Authorization for Release of Health Information to firstname.lastname@example.org or mail to:
The College of New Jersey
Student Health Services
P.O. Box 7718
Ewing , New Jersey 08628
There is no charge for this service. Allow 7 business days for processing of request.
If picking up your records in-person, bring your Driver’s License with photo ID so that we can verify your identity.
*You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) Files. It is FREE.
The Authorization for Release of Health Information cannot be used to release health information relating to future medical care nor can it be used to release medical records from an entity other than TCNJ Student Health Services. Current Student Health Services’ patients may only use this form to request copies of PAST medical or immunization records.
Should a patient 18 or over wish to release specific medical information to a third party such as a parent or family member, they should inform their Student Health Services’ health care provider during or immediately after their visit. As each visit is treated individually, the patient must inform their health care provider of their wishes at each visit.
MEDICAL RECORD REQUESTS FOR YOUR RECORDS FROM PLANNED PARENTHOOD: To request your health records from Planned Parenthood of the Mercer Area Inc., contact them at their TCNJ office at (609) 771-2110. Please note that Planned Parenthood is open only during the Fall and Spring semesters. They are closed during semester breaks and in the summer. If you need your health record and Planned Parenthood is closed, please call the Planned Parenthood main office at 437 East State Street, Trenton, N.J. at (609) 599-4881.
MEDICAL RECORD REQUESTS FOR YOUR RECORDS FROM COUNSELING & PSYCHOLOGICAL SERVICES (CAPS): Call their office at (609) 771-2247.