To request a copy of your medical records, download the Release of Information form (see below) and fax or mail it to the appropriate facility. Please be advised there may be a cost involved for this service.

-Release of Information form
-Release of Information form (Spanish version)

Veterans, Share your Medical Information With Us


Fax or mail completed form to:

Richmond, VA

Memorial Regional Medical Center
8260 Atlee Road
Mechanicsville, VA 23116
804-764-6427
Fax: 804-764-6324

Richmond Community Hospital
1500 N. 28th Street
Richmond, VA 23223
804-225-1778
Fax: 804-225-7359

Rappahannock General Hospital
101 Harris Road
Kilmarnock, VA 22482 
804-435-8550
Fax: 804-435-0467

St. Francis Medical Center
5801 Bremo Road
Richmond, VA 23226
804-281-8135
Fax: 804-673-9561

St. Mary's Hospital
5801 Bremo Road
Richmond, VA 23226
804-281-8135 
Fax: 804-673-9561

Baltimore, MD

Bon Secours Hospital
2000 West Baltimore Street
Baltimore, Maryland  21223  
Phone:  410-362-3044
Fax: 410-233-2063

Hampton Roads, VA

Bon Secours DePaul Medical Center 
150 Kingsley Lane 
Norfolk, VA 23505 
Health Information Management Department
Hours: 8 am to 4:30 pm, Monday through Friday
Telephone: 757-889-5266, option #1
Fax: 757-889-5913  

Bon Secours Mary Immaculate Hospital 
2 Bernardine Dr. 
Newport News, VA 23602 
Health Information Management Department
Hours: 8 am to 4:30 pm, Monday through Friday
Telephone: 
757-886-6560, option #1
Fax: 757-886-6814

Bon Secours Maryview Medical Center
3636 High St. 
Portsmouth, VA 23707 
Health Information Management Department
Hours: 8 am to 4:30 pm, Monday through Friday
Telephone: 
757-398-2250, option #1
Fax: 757-398-2241

Ashland, KY

Our Lady of Bellefonte Hospital
1000 St. Christopher Drive
Ashland, KY 41101
606-833-3141
606-833-3140 fax

Greenville, SC

St. Francis Downtown

1 St. Francis Drive

Greenville, SC 29601

Phone:  (864) 255-1375

Fax: (864) 255-1644

 

St. Francis Eastside

125 Commonwealth Drive

Greenville, SC 29615

Phone: (864) 675-4269

Fax: (864) 675-4279

 

 

Medical records will not be released without a written authorization. To authorize us to forward a copy of your medical record directly to a physician, you must complete the Authorization to Release Protected Health Information form, which is available from our offices.