Requesting your Medical, Behavioral, or Dental Records

If you are transitioning your care outside of CCS, you will be required to complete a Records Release Form in order for us to legally share your records and care information with your next provider.

A Records Release Form may be provided by your new care location, or you can download the CCS Release linked below.

CCS Release of Records Form

For CCS MEDICAL and/or BEHAVIORAL records (excluding Dental records),please fax the completed form to 207-777-8958 (ATTN: Medical Records Dept./HIMS),

or drop it off/mail it to:

St. Mary’s Medical Records/HIMS

93 Campus Ave, C Wing, Ground Floor

Lewiston, ME 04240

For CCS DENTAL records, including X Rays, please fill out the information below. Please note that we will need a record’s release form before we can share records with another dental practice. You can upload a word, image or pdf file when you submit the request below. If you cannot attach to the form below, please email us the form @ Pedsdentalrecordsrequest@communityclinicalservices.org

CCS Release of Records Form