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How to Request
To receive a copy of your medical record, you must submit a written request to the Health Information Management Department (HIM). The Client Request to Access Records Form must be completed and signed by the client, parent (if the patient is under 18 years of age) or legal guardian and a copy of identification or legal document that gives authority to access included with the form. Processing time for requests is 30 days from the date your request is received.
Client Request to Access Records Form
Fees:
$0.37 per page for 1-50
$0.18 per page for 51+
$5.00 for electronic copy on CD
$10.00 for handling and postage
$0 charge for pdf electronic copy sent via secure email
Contact Info
Health Information Department
Phone: 804-727-8674
Fax: 804-727-8355
Email: [email protected]
Questions?
For more information please call 804-727-8674
