We will gladly release your medical records, but we’ll first need your written authorization. Please print and complete the following form:
If you are unable to print this form from your computer, please call us at 804-285-2300, ext 1105. We will be glad to mail a form to you.
Once completed, you can mail, fax, or hand-deliver the authorization form to us:
Medical Records Department
P. O. Box 71690
Richmond, VA 23255-1690