Medical Records

To receive a copy of your medical record, you must submit a written request to the Health Information Management Department (HIM). A letter or authorization form signed by the patient or parent (if the patient is under 18 years of age) must accompany all requests for release of information. Download a copy of the Medical Records Request form here: Medical Records Request - English | Medical Request Form - Spanish.  

If you are the next of kin, you will need to complete the Medical Records Request form with the Right to Access form and a copy of the death certificate.  Download a copy of the right to access form here: Right to Access.

Processing time for requests is 10 - 15 business days from the date your request is received.

If you are a doctor's office, please use the MD Request form.  Download a copy of the MD Request form here: MD Request.

Adobe Acrobat Reader is required to print.

Charges:

• $.50 for 1- 50 per page
• $.25 for 51+ per page
• $1.00 per page for microfiche records
• postage fees

Virginia Hospital Center has contracted with HEALTHPORT to process our billing copies of medical records.  Billing questions?  Please call 800.464.0035.

Your request must include the following:

• Virginia Hospital Center as addressee
• Patient's full name
• Patient's date of birth
• Hospital visit dates for information being requested
• Purpose of request
• Name and address of facility or person to receive the medical record copies
• Patient signature (or signature of patient's legal guardian, if the patient is under 18 years of age)
• Date of request
• Daytime phone number

Send the completed letter or authorization form to:

Virginia Hospital Center
1701 North George Mason Drive
Arlington, Virginia 22205
Attn: Health Information Management Department
Fax Number: 703.558.6979

Birth certificates must be obtained from Department of Vital Records in Richmond. Please contact Vital Records directly at 804.662.6200 or at the following Internet address: www.vdh.state.va.us

To contact the Health Information Management Department please call 703.558.6116.