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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.


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
Electronic Copy: Flat fee of $6.50/request (CD)
Any request on Paper or Paper/Electronic combination: $0.10 per page/request
Paper uploaded to CD: $0.08 per page/request
NOTE: HVHS no longer has walk in services. The section on the request for appointment is to review records only, not to obtain copies.

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

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Heritage Valley Health System

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

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

Heritage Valley Sewickley
701 Broad Street
Sewickley, PA 15143 USA

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Phone: 1.877.771.4847

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