Request Medical Records

We will gladly release your medical records. We will need your written authorization to do this.

Complete our authorization form

Patient Authorization for Release of Medical Information

If you are unable to print this form from your computer, please call us at (804) 330-4021, option 6. We will mail the form to you. You can also pick up a form at one of our offices.

Send this form to our Medical Records Department

By mail:
RGA Medical Records Department
223 Wadsworth Drive
N. Chesterfield, VA 23236

By fax:
(804) 330-4137
Attention: RGA Medical Records Department

In person:
You can drop off this form at any of our offices.

Please know:

  • You should allow at least 15 days for your request to be processed.
  • If you pick-up your medical records in person, you will be asked to show a photo ID.
  • There may be a small charge for this service.