Request Medical Records

Requests for Medical Records | Fees | Exceptions 
Other Charges | Addresses and Phone Numbers 

Requests for Medical Records
Because an actual signature is required to release medical records information, personnel at Texas Health Resources facilities are not allowed to process requests or authorizations received via e-mail. Please download the Authorization for Release of Patient Information, complete all required fields, sign it, and mail the form to the Medical Records Department of the relevant Texas Health hospital. Addresses for all system hospitals are included on the download form and are also available at the bottom of this page.

Authorization for Release of Patient Information
 

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Fees
The Texas Legislature sets the fees our hospital charges for copies of medical records. This is found in S241.154(e) of the Health and Safety Code. These charges are reviewed and updated annually based on the price index as published by the Bureau of Labor Statistics of the United States Department of Labor. The following fees are effective at Texas Health hospitals as of January 1, 2009:

Medical Records in Paper Form
Each hospital charges the following fees for the copying of health care information. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.

1-10 pages:	$42.54
11-60 pages:	$1.43 per page
61-400 pages:	$0.71 per page
More than 400 pages:	$0.37 per page

Records Stored on Other Medium
If the requested records are stored on any microform or other electronic medium, the hospital charges the following fees. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.

1-10 pages:	$64.81
Subsequent pages:	$1.43 per page

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Exceptions
Local, state or federal agencies requesting health care information may be entitled by statute to a different fee. The agency should inform the hospital of this fact, or information can be obtained from the Legal Department.

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Other Charges
The hospital may charge a reasonable fee for:

1. Execution of an affidavit or certification of a document, not to exceed the charge authorized by Section 22.004, Civil Practice and Remedies Code; and
2. Written responses to a written set of questions, not to exceed $14.40 for a set.

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Addresses and Phone Numbers 
Please mail the requested documentation to the relevant hospital address, listed below.  Note that individuals requesting medical records must present a government-issued photo ID at the time of pickup. 

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