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
Requests by Location
Inova Alexandria Hospital and Inova Healthplex – Franconia/Springfield
703-504-3410
Fax: 703-504-3411
Mailing address:
Medical Records 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, Inova Heart and Vascular Institute, Inova Emergency Care Center – Fairfax and Inova Emergency Care Center – Reston/Herndon
703-776-3307
Fax: 703-776-6456
Mailing address:
Medical Records, Attn: Release of Information, 3300 Gallows Road, Falls Church, VA 22042
Inova Loudoun Hospital
703-858-6625
Fax: 703-858-6622
Mailing address:
Medical Records, 44045 Riverside Parkway, Leesburg, VA 20176
Inova Medical Group
703-914-6030
Fax: 571-665-6860
Inova Mount Vernon Hospital
703-664-7123, option 1
Fax: 703-664-7543
Mailing address:
Medical Records, 2501 Parkers Lane, Alexandria, VA 22306
