Medical Records Request

Make a Request To receive a copy of your medical record, print out and complete our authorization form below and mail or fax it to the hospital or facility where you received service. Appropriate address and fax numbers, along with a contact number for more information, are listed further below on the page. Authorization to Release/Disclose Protected Health Information Forms English Arabic Chinese (Mandarin) Korean Spanish Vietnamese Requests by Location Inova Alexandria Hospital and Inova Healthplex – Franconia/Springfield Expand Content 703-504-3410 Fax: 703-504-3411 Mailing address: Medical Records Department, 4320 Seminary Road, Alexandria, VA 22304 Inova Fair Oaks Hospital Expand Content 703-391-3829 Fax: 703-391-3058 Mailing address: Medical Records, Attn: Release of Information, 3600 Joseph Siewick Drive, Fairfax, VA 22033 Inova Fairfax Hospital, Inova Children's Hospital, Inova Heart and Vascular Institute, Inova Emergency Care Center – Fairfax and Inova Emergency Care Center – Reston/Herndon Expand Content 703-776-3307 Fax: 703-776-6456 Mailing address: Medical Records, Attn: Release of Information, 3300 Gallows Road, Falls Church, VA 22042 Inova Loudoun Hospital Expand Content 703-858-6625 Fax: 703-858-6622 Mailing address: Medical Records, 44045 Riverside Parkway, Leesburg, VA 20176 Inova Medical Group Expand Content 703-914-6030 Fax: 571-665-6860 Inova Mount Vernon Hospital Expand Content 703-664-7123, option 1 Fax: 703-664-7543 Mailing address: Medical Records, 2501 Parkers Lane, Alexandria, VA 22306