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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


Inova Alexandria Hospital

703-504-3410
Fax: 703-504-3411
Mailing address:
Medical Record Department, 4320 Seminary Road, Alexandria, VA  22304


Inova Fair Oaks Hospital

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 (formerly Inova Fairfax Hospital for Children), Inova Heart and Vascular Institute, Inova Emergency Care Center – Fairfax, Inova Emergency Care Center – Reston/Herndon and Inova Healthplex – Franconia/Springfield

703-776-3307
Fax: 703-776-6456
Mailing address:
Medical Records, Attn: Release of Information, 3300 Gallows Road, Falls Church, VA  22042


Inova Mount Vernon Hospital

703-664-7123, option 2
Fax: 703-664-7543
Mailing address:
Medical Records, 2501 Parker’s Lane, Alexandria, VA  22306


Inova Loudoun Hospital

703-858-6625
Fax: 703-858-6622
Mailing address:
Medical Records, 44045 Riverside Parkway, Leesburg, VA  20176


Inova Surgery Center at Countryside (ISCC)

703-444-6060
Fax: 703-444-2278
Mailing address:
Medical Records, 4 Pidgeon Hill Drive, Sterling, VA  20164