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Release of Medical Information

The Department of Health Information Management has contracted with a copy service, Cardone Record Services, to process requests for medical records. To request medical information, download the Authorization Formto Release Confidential Health Care Information, complete the form in it's entirety, sign, date, and mail the form to the following address:

VCU Health Community Memorial Hospital
Attention: Health Information Management/Medical Records
P.O Box 90

South Hill, VA 23970

Requested copies of medical information will be provided within 15 days of receipt.


$.37 per page up to page 50
$.18 per page, page 51 and up, Cap Fee of $150

CD/DVD $10.00

Please note, records will be faxed at no cost directly to provider for continuity of care.

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