Medical Records

To expedite your request, please complete the medical record request in its entirety. If you have questions about how to complete the request, contact our Health Information Department at 610-278-2217.

How can I request my medical records?

1. Mail-in Requests
2. Fax Medical Records Requests

Where can I send my medical records requests?

You may submit your request by mail to:

Attn: Medical Records/ROI  

2701 Dekalb Pike  

Norristown, PA 19401  

You may also fax the request to: 610-278-2858. You can use the provided link for the ROI-Authorization form to print a copy of the release of information form. Please complete the form in its entirety and fax it to the secured Health Information fax at 610-278-2858.

What if I am requesting records for my physician and an upcoming appointment for continuity of care?

Please have your physician fax the request to 610-278-2858. Additionally, please note the date needed or your appointment date so that the request can be expedited. Ensure that the physician’s name, phone number, and fax number are printed clearly and visibly.

When will I or the third party receive a copy of my medical record?

Medical record requests are processed within 15 business days from the date the request is received by the Suburban Behavioral Health Campus of Roxborough Memorial Hospital (Suburban Medical Group (SMG) requests must be sent to the SMG office). Requests for physician offices or other healthcare facilities are processed the same day.

You can also call the Release of Information Department for additional information regarding obtaining copies at 610-278-2217. If you have any further questions or problems, please contact the HIM manager at 610-278-2217. 

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Health Information and Medical Records

Photocopies of your records are available upon request and will be released only with appropriate patient authorization and/or in accordance with applicable state and federal laws. This is to ensure compliance with all federal and state laws and to safeguard your confidentiality. A Release of Information Specialist may contact you regarding this request. To process your request efficiently, please include the following information:

• Patient Name
• Date of Birth
• Date(s) of Service
• Information needed
• Purpose of the request
• Name of the individual authorized to receive the information
• Signature of the patient, legal guardian, or individual authorized by law to release medical records on behalf of the patient
• Please include a phone number where we can reach you in case there are questions about your request and a clear copy of your photo ID.
  • If you are requesting records for someone other than yourself, you must provide a copy of the Power of Attorney documentation.
  • If you are requesting records for someone who is deceased, you must provide a copy of the will listing you as the Executor/Executrix or a copy of the death certificate with your name as the Informant.

You may use the link provided to print a copy of the release of information form. Please complete the form in its entirety and fax it to the secured Health Information fax at 610-278-2858. 

This information is included in our ROI Authorization, so a separate authorization is not required. Please note that if you are aware of any protected information (e.g., psychiatric, psychological, drug abuse, alcoholism, or HIV infections), you will need to fill out a special authorization, which can be obtained by calling a Release of Information Representative at 610-278-2217.