Skip to main content
Heritage Valley Health System
  • Find a Doctor
  • Locations
  • Services
  • Patient & Visitor Resources
  • Home
  • About
  • Careers
  • Residencies & Schools
  • Foundation
  • News
  • Events
  • Contact
  • Pay My Bill
  • Health Link Patient Portal
Download the HVHS App Today!
  • Home
  • About
  • Careers
  • Residencies & Schools
  • Foundation
  • News
  • Events
  • Contact
Heritage Valley Health System
  • Pay My Bill
  • Health Link Patient Portal
  • Find a Doctor
  • Locations
  • Services
  • Patient & Visitor Resources

Home Patient & Visitor Resources Health Information Management (Medical Records)

Health Information Management (Medical Records)

Heritage Valley Health System works with an outside source to coordinate providing copies of medical records to patients and/or authorized people.



Download Release Form

Download the Medical Records Release Form, complete it and send to the Medical Records Department:

Heritage Valley Sewickley
Medical Records Release of Information
720 Blackburn Road
Sewickley, PA 15143

Note:  Please complete all appropriate sections on the 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 under both the Patient Rights section and the Sensitive information section of the form in order for the form to be processed.


Schedule Pick-up for Medical Records

Please call the Medical Records Department at 724.773.7600.
Select Patient, Medical Records, Release of Information, then Schedule Pick-up / Other.


Request Release Form

Request the Medical Records Release form be sent to you by contacting the Medical Records Department at 724.773.7600.
Select Patient, Medical Records, then Release of Information.


Fees

Heritage Valley Health System 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.

Rates:

Patients & Patient Representatives

How the PHI is Maintained Requested Format of PHI Reasonable, Cost-Based Fee
Hybrid (includes Electronic Health Record (EHR) and/or paper). CR-ROM Flat fee of $6.50 (inclusive of actual labor, supplies) plus postage and applicable sales tax.
Hybrid (includes Electronic Health Record (EHR) and/or paper). paper mailed, picked up or emailed Flat fee of $6.50 (inclusive of actual labor, supplies) plus applicable sales tax. Postage if mailed, no postage if emailed.
Paper only (does not include Electronic Health Record (EHR)). CD-ROM Flat fee of $6.50 (inclusive of actual labor, supplies) plus postage and applicable sales tax.
Patient Portal – Follow My Health Smartphone, laptop or computer No charge.

Attorneys & Copy Services
$25.20 search and retrieval fee
$1.70 / page (1-20 pages)
$1.26 / page (21-60 pages)
$0.44 / page (61 + pages)
Actual postage

District Attorney and Public Defenders
Copy Charges: $25.40 / request

Requests for Social Security or Federal/State Financial Needs-Based Service
Copy Charges: $31.94 / request

Requests for Disability Benefits
Copy Charges: $31.94 / request


Questions?

For Heritage Valley Health System records, contact Release of Information staff at 724.773.7600

  • Overview
  • Billing & Payments
    • Charity Care
    • Asistencia Financiera
    • Insurance Coverage
    • Financial Assistance
  • Care Card
  • Download Our App
  • Health Information Management (Medical Records)
  • Health Link Patient Portal
  • Hearing Impaired Services
  • HIPAA Privacy Notice
  • Hospital Amenities
  • My Care Link
  • Patient Education
  • Patient Guide
  • Pricing Transparency
  • Safe Haven
  • Smoking Policy
  • Surprise Billing Rights
  • Visitor Restrictions
  • Volunteers
  • Overview
  • Billing & Payments
    • Charity Care
    • Asistencia Financiera
    • Insurance Coverage
    • Financial Assistance
  • Care Card
  • Download Our App
  • Health Information Management (Medical Records)
  • Health Link Patient Portal
  • Hearing Impaired Services
  • HIPAA Privacy Notice
  • Hospital Amenities
  • My Care Link
  • Patient Education
  • Patient Guide
  • Pricing Transparency
  • Safe Haven
  • Smoking Policy
  • Surprise Billing Rights
  • Visitor Restrictions
  • Volunteers

Heritage Valley Health System

Locations

Heritage Valley Beaver
1000 Dutch Ridge Road
Beaver, PA 15009 USA

Heritage Valley Kennedy
25 Heckel Road
McKees Rocks, PA 15136 USA

Heritage Valley Sewickley
701 Broad Street
Sewickley, PA 15143 USA

All Locations
Contact

Phone: 1.877.771.4847

Connect
  • Facebook
  • Twitter
  • LinkedIn
  • Youtube
  • Instagram
  • Privacy Policy
  • Non-Discrimination Policy
  • Vendor Relations
  • Employee Portal
  • Request A Care Card

Copyright © 2023 Heritage Valley Health System. All rights reserved.

Website by Imagebox