United States Department of Veterans Affairs

VA Maryland Health Care System

Release of Information

Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

  • access to your medical records
  • obtaining copies of your medical records
  • requests to amend your medical records
  • completion of forms for benefits, insurance, and other reasons

The Release of Information Staff has expert knowledge in our patients' rights and their medical records.

The Release of Information Office is located in the Health Information Management Section of Medical Administration Service at the Baltimore and Perry Point VA Medical Centers.  The phone numbers for the Release of Information Offices are:

  • Baltimore VA Medical Center: (410) 605-7348
  • Perry Point VA Medical Center: (410) 642-2411, ext. 6028

How to Request Information

To request a medical record, please complete one of the forms listed in the column to the right.  You need to complete the requested information, sign the form, and mail or fax it to one of the following Release of Information Offices:

Baltimore
VA Medical Center
Health Information Management Section  (136D)
Release of Information
10 North Greene Street
Baltimore, MD  21201
(Fax) 410-605-7895

OR

Perry Point
VA Medical Center
Health Information Management  Section (136D)
Release of Information
Perry Point, MD  21902
(Fax) 410-642-1123

Because forms must contain an original signature, e-mailed forms cannot be accepted.

Requests for records will take approximately 10-20 business days to process.

Fees

There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.

 

Release of Information Forms


pdf document 

Request for and Authorization to Release Medical Records or Health Information (VA 10-5345) 

Individuals' Request for a Copy of Their Own Health Information (VA 10-5345a) 

Related Links

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Notice of Privacy Practices