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HeritageValley Health System works with an outside source to coordinate providing copies of medical records to patients and/or authorized people. To process a request to obtain copies of medical records, follow one of the following options:

• Request the Medical Records Release form be sent to you by contacting the appropriate Medical Records Department:
  • Heritage Valley Beaver: 724.773.7600
  • Heritage Valley Sewickley : 412-749-7187
• Download the Medical Records Release form, complete it and send to the appropriate Medical Records Department:
  • Heritage Valley Beaver, Medical Records Release of Information, 1000 Dutch Ridge Road, Beaver, PA 15009
  • Heritage Valley Sewickley , Medical Records Release of Information, 720 Blackburn Road, Sewickley, PA 15143
• Note: Please complete all appropriate sections on form. Make sure to include a phone number where you can be reached in case additional information is required. On page 2, a signature is required in under both the Patient Rights section and the Sensitive information section of the form will not be able to be processed.
• Questions?
  • For Heritage Valley Beaver records contact Release of Information staff at 724.773.7600
  • For Heritage Valley Sewickley records contact Release of Information staff at 412-749-7187,
  HVHS works with an outside service to process medical records requests. Fees for processing a medical record are based on fees set by the Pennsylvania Department of Health as follows, effective January 1, 2006:

Requestor	Copy Charges
Patients, Patient Representatives, Attorneys & Copy Services	$19.00 search and retrieval fee $1.28/page (1-20 pages) $ .95/page (21-60 pages) $ .32/page (61 + pages) $1.88/page (microfilm copies) actual postage
District Attorney and Public Defenders	$19.00/request
Requests for Social Security or Disability Benefits	$24.08/request
Requests for continued care, Military	No charge