Medical Records

Your Medical Records. Delivered!

Your medical records are safe and secure at GWPSA and may be requested by patients, if required.

Requesting Your Medical Records

To make it easy for you, you can download and print our Medical Information Release form or obtain one from our office.

You can request records from GWPSA's Medical Records Department in the following ways:

• Mail or Fax the completed Medical Information Release Form.
• Call GWPSA's Medical Records Department at (703) 544-8971.

Cost

We will send your medical records to you upon receipt of the signed record request form and necessary payment. Our Medical Record's Department will a provide cost estimate based on records requested.

Payments may be made in the most convenient way for you.:

• Write a check in favor of "Greater Washington Plastic Surgery Associates" and mail along with the signed Medical Record Release Form
• Our office can also generate an electronic invoice which can be paid online using a credit card.

Authorization Signature for Your Records Release

By law, the following authorized people are able to sign for the release of your health information:

• Yourself (not your spouse)
• A parent (for patients younger than 18 years of age)
• A minor who has a child or who is aged 12 – 17 and is under the care of a psychiatrist and/or in drug/alcohol treatment
• Legal guardian (guardianship documentation is required)
• Power of attorney if patient is unable to sign (legal documentation is required)
• Estate representative for a deceased patient (estate documentation is required)