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Request Medical Records

 

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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 Nov. 22, 2013:

Current Fees Statute
Provided in Paper Form
(Non-Patient Personal Use Requests)
1 to 10 pages - $45.02
11 to 60 pages - $1.51 per page
61 to 400 pages - $0.75 per page
More than 400 pages - $0.40 per page 
Health and Safety Code 241
Stored on Microfilm 1 to 10 pages - $68.58
Subsequent pages - $1.51 per page
Health and Safety Code 241
Stored Digital or Electronic AND
Requested in Digital or Electronic Form
$81.57 Health and Safety Code 241
Affidavit or Subpoena $1.00 Civil Practice and Remedies Code 22.004
Written Responses $10.00 for a set Health and Safety Code 241

For Patient Personal Use
Provided in Paper Form
(If requesting for Disability/Worker's Comp, there is no charge, but patient must show proof of appointment/hearing)

1 to 10 pages - Complimentary
11 to 60 pages - $1.51 per page
61 to 400 pages - $0.75 per page
More than 400 pages - $0.40 per page

Texas Health Resources/
Health and
Safety Code 241

For Patient Personal Use
Requested in Digital or Electronic Form
$81.57 Health and Safety Code 241
Worker's Compensation Initial Fee - $5.00
1 to 20 pages - $0.50 per page
21 or more pages - $0.30 per page
TDI - DWC Rules Chapter 134.5

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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

1. Postage fees may apply to requests that are mailed.   

2. Execution of an affidavit or certification of a document, not to exceed the charge authorized
by Civil Practice and Remedies Code, §22.004.

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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. 

Texas Health Harris Methodist Hospital Alliance
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Arlington Memorial Hospital
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Harris Methodist Hospital Azle
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243 

Texas Health Harris Methodist Hospital Cleburne
Health Information Services Department
201 Walls Drive
Cleburne, TX 76031
817-556-5401

Texas Health Harris Methodist Hospital Fort Worth
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Harris Methodist Hospital Hurst-Euless Bedford
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Harris Methodist Hospital Southwest Fort Worth
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Harris Methodist Hospital Stephenville
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Specialty Hospital Fort Worth
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Presbyterian Hospital Allen
Health Information Management Services Department
Release of Information
612 E. Lamar Blvd., Suite 800
Arlington, TX 76011
1-855-681-8243

Texas Health Presbyterian Hospital Dallas
Health Information Services Department
8200 Walnut Hill Lane
Dallas, TX 75231-4402
214-345-7670

Texas Health Presbyterian Hospital Denton
Health Information Management Services Department
Release of Information
3000 North Interstate 35
Denton, TX 76201
940-898-7176

Texas Health Presbyterian Hospital Kaufman
Health Information Management Services Department
Release of Information
850 Ed Hall Drive
Kaufman, TX 75142
972-932-5435

Texas Health Presbyterian Hospital Plano
Health Information Management Services Department
Release of Information
6200 West Parker Road
Plano, TX 75093-7914
972-981-8667

 

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