Medical Records
How to Request
To receive a copy of your medical record, you must submit a request to the Health Information Management Department (HIM). Please click on the link below titled Request Medical Records and fill out our online Release of Information form.
- Request Medical Records
- 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.
- If you are a doctor's office, please download the MD Request form.
What to Include
Your request must include the following:
- Address to: VHC Health
- 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: VHC Health
Attn.: Health Information Management Department
1701 North George Mason Drive
Arlington, Virginia 22205
Fax: 703.558.8699
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
VHC Health has contracted with CIOX to process our billing copies of medical records. For billing questions, please call 800.464.0035.
Proxy Access to MyVHC Patient Portal:
How to Request
Access to a patient’s MyVHC Portal Account is available by requesting Proxy Access. Parent/Legal Guardian/Power of Attorney access to a minor’s patient portal account is available until the child reaches 18 years of age. Adult/Legal Guardian/Power of Attorney access to an adult patient’s portal account is also available.
- Download a copy of the Proxy Access Request Form: English version | Spanish version
- Please complete and sign the relevant sections of the form.
- For both Adult and Minor patient access, select the correct proxy type. Each proxy type has its own requirements for supplemental documentation.
- Submit the completed form by faxing any supplemental documentation to Health Information Management Department at 703.558.8699. To email the completed form, please send the document to MyVHCHelp@vhchealth.org.
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