To request a copy of your medical records for yourself or another physician, please print out and complete the release form below, then send it to us:
Mail your request to:
2901 Telestar Court, Suite 300
Falls Church, VA 22042
Fax your request to:
Requested information from your medical record is sent free of charge when needed for follow-up care. There is a fee for copies requested for personal use.
Your health information will be kept confidential and viewed only by our personnel who need to know your medical and billing information to perform their jobs.