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  • General Medical Records Release Form - Medstar Transport

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Information: Patient Name: Address: Phone: Date of Birth: / / Medical Record Number: I request a copy of my medical records covering the dates to . I agree to be responsible for the cos.

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Medical facilities have 30 days to release requested medical records, and if this time frame is not met, an extension of 30 additional days can be granted if a letter is sent to the requestor with explanation as to why the request is delayed. Note: By law, only one extension period is allowed.

Leonardtown, MD – On Wednesday, Jan. 13, MedStar St. Mary's Hospital will join MedConnect, the electronic health record used throughout the MedStar Health system.

A patient may request a copy of his/her medical record by a written request. The written request must contain the following information: Patient's Name. Date of Birth.

To learn what's required to obtain your medical records, call the provider's office or visit the health information management (HIM) department. Authorization forms may also be available online. When picking up your records, be sure to bring a government-issued photo ID.

To request the release of your medical information, fill out our medical records release form. For more information, call 202-877-7181 or visit our Medical Records page.

MedStar Washington Hospital Center in Washington, DC is nationally ranked in 1 adult specialty and rated high performing in 2 adult specialties and 15 procedures and conditions. It is a general medical and surgical facility. It is a teaching hospital.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232