Medical Record/X-Ray Copy Requests

It is the responsibility of Your Doc’s In to insure that copies of medical records are only released to those individuals as authorized by the patient/responsible party, and in accordance with state and federal guidelines.

If a patient/responsible party would like their medical records released to their primary care physician (PCP) or other health care provider:

• If the patient’s primary care physician (PCP) was listed on the Patient Registration Form at the time of the visit, we will automatically fax a copy of that information directly over to the PCP.
• If the health care provider was not listed on the Patient Registration Form at the time of the patient visit, you will need to complete the Medical Records Release form and send it, along with a copy of your photo ID to our medical records department. You can fax that information to (410) 334-6352 or mail the request to:

Our medical records department can be reached at (410) 334-6351 xt. 3015.

If a patient/responsible party would like a copy of their own medical records or have them released to another individual:

• We will need you to complete the Medical Records Release Form and send it, along with a copy of your photo ID to our medical records department. You can fax that information to (410) 334-6352 or mail the request to:

Please note that there may be a cost associated with the request, based on the amount of medical records being sent and in accordance with the fee structure established by the state of Maryland. This fee must be paid prior to the records being released.

If a copy of your x-rays is needed:

• We can provide a CD with the x-ray images on the disc. If the request is within 30 days of the date you were seen by us, and are for a specialist that you were referred to, there is no cost for the x-ray copies. Otherwise, the cost for the x-ray copies is $10.00 for the CD and must be paid prior to the receipt of the x-ray disc.

If you have any questions, you can contact our medical records department at (410) 334-6351 xt. 1075.