Fayetteville VA Coastal Health Care System
Request Your Medical Records
Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.
We can assist you with the following —
- access to your medical records
- obtaining copies of your medical records
- requests to amend your medical records
- completion of forms for benefits, insurance, and other reasons
- The Release of Information Staff is expert in our patients' rights and their medical records.
How to Request InformationTo request a medical record, please complete one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address —
Because forms must contain an original signature, e-mailed forms cannot be accepted.
FeesThere is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.
Right to Access and/or Review Medical Information
Requests for access (to look at or to review) or copies of, individually-identifiable information need to be processed in accordance with all Federal laws including FOIA, Privacy Act, and HIPAA. Except as otherwise provided by law or regulation, individuals, upon written request, may gain access to, or copies or, their individually-identifiable information or any other information pertaining to them that is contained in any system of records or designated record set maintained by VHA. VA Form 10-5345a, Individual's Request for a Copy of Their Own Health Information, may be used as the written request requirement.