• Connect With Us
Patients & Visitors

Medical Records

How to Request

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

  1. Download a copy of the Medical Records Request Form: English | Spanish
  2. If you are the next of kin, you will need to complete the Medical Records Request form with a copy of the death certificate the Right to Access form.
  3. If you are a doctor's office, please download the MD Request form.

What to Include

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

Where to Send

Send the completed letter or authorization form by mail or by fax to:

Address: Virginia Hospital Center
Attn.: Health Information Management Department
1701 North George Mason Drive
Arlington, Virginia 22205
Fax: 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 go to www.vdh.state.va.us.

Fees

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

Virginia Hospital Center has contracted with HEALTHPORT to process our billing copies of medical records. For billing questions, please call 800.464.0035.

Share:
Contact Info

Health Information Management Department

  • Phone: 703.558.6116
  • Fax: 703.558.6979

 

Adobe Acrobat Reader

Adobe Acrobat Reader is required to print.
Get Adobe Reader

1701 N. George Mason Drive | Arlington, VA 22205-3698 | tel 703.558.5000
© 2017 Virginia Hospital Center All rights reserved