Medical Records
To request records please complete the Medical Records Release Authorization form and return to Connecticut Eye Consultants:
E-mail: Medicalrecords@danburyeye.com
Fax: 203-778-6238
Mail: Attn: Medical Records Department
Connecticut Eye Consultants PC
69 Sand Pit Road
Danbury, CT. 06810
PLEASE BE ADVISED THAT THE OFFICE HAS UP TO 30 DAYS TO PROCESS YOUR REQUEST FOR RECORDS.
There is no charge for records released to another provider. However, there is a charge of $0.65 per page plus postage, for all personal copies of requested records. This fee will be assessed after the records are printed.
Completion of Forms
School reports, DMV Jury Duty, Disability, Detailed work excuse, AFLAC forms etc.
Please make sure all personal information including non-work dates if applicable are completed and the form signed BEFORE IT IS SUBMITTED TO THE OFFICE. Blank and incomplete forms will be returned to the patient. To expedite completion, please make sure you have signed a release granting Connecticut Eye Consultants permission to disclose your personal health information to the designated entity. Sign and date that release.
EFFECTIVE JANUARY 1, 2025, ALL FORMS ARE SUBJECT TO A COMPLETION FEE AS FOLLOWS:
$25 PER FORM
$40 FOR FORMS 3 OR MORE PAGES.
