Dental Record Requests

Contact Info

Email
Fax: (617) 636-6858

Address

Tufts University School of Dental Medicine
1 Kneeland Street
Boston, MA 02111
Attn: Record Department

Directions

Hours

8:30 a.m. – 5:00 p.m., Mon-Thu;

8:30 a.m. – 4:30 p.m., Fri

To obtain a copy of your dental record, you will need to submit a completed Record Request Form available for download by clicking on the link below. Once you have downloaded and completed the form, please allow up to 30 days for requests to be completed.

There is a small fee associated with processing requests that are provided directly to the patient. Record requests from dentists/dental offices are provided free of charge, so consider having your dentist or dental office handle this process.

Download Record Request Form*

Fees:

Fees must be paid in full before releasing records. Record requests from dentists/dental offices are provided free of charge, so consider having your dentist or dental office handle this process.

  • Inspect or review in person (no copy) = No Charge
  • A paper/electronic copy of only billing records = No Charge
  • Record Only (Paper copy or Digital) = $6.00
  • Record (Paper copy or Digital) plus X-Rays (Film or CD) = $10.00

Request Methods:

You can provide us your completed Record Request Form in the following ways. Please indicate your preferred method when you fill out the Record Release Form.

  • Fax your completed release form to (617) 636-6858. You can then call in your credit card payment to (617) 636-6986.
  • Email your completed request form as an attachment to dental-compliance@tufts.edu. You can then call in your credit card payment to (617) 636-6986.
  • Mail your completed release form along with your payment by check or money order to the address below.
    • Tufts University School of Dental Medicine
      1 Kneeland Street
      Boston, MA 02111
      Attn: Record Department
  • Hand Deliver your completed form to us in person, by visiting 1 Kneeland St., Boston and speaking with a person at the front desk. Please have your check, money order, Visa, Master Card or Discover Card ready.

Delivery Methods:

You can receive your record in the following ways. Please indicate your preferred method when you fill out the Record Request Form.

  • Review in person at TUSDM
  • Pick up at TUSDM
  • Fax
  • Secure Email
  • Standard Mail