Medical Records

Release of Information Request Form

Welcome to The GW Medical Faculty Associates Release of Information Request page. View the list of our frequently asked questions.

Please follow these important steps:

  • To request a copy of your outpatient records, you’ll need to download the Authorization to Release Protected Health Information form authorizing The GW Medical Faculty Associates to release your medical records.
  • Complete all fields on the authorization form(s).
  • After you complete, sign and date the authorization form(s), you can either
    • Fax the completed form(s) to (202) 741-2405 or (202) 741-2431
    • Or mail the form(s) to the addresses listed below:

 

Patients Walk-In/Mail Requests to:
2150 Pennsylvania Ave, NW Suite 2B-440
Washington, DC 20037
Phone: (202) 741-2404
Fax: (202) 741-2431

Hours of Operation:
Monday - Friday: 8:30 a.m. - 4:00 p.m.
Closed for Lunch Daily: 12:00 p.m. - 1:00 p.m.

 

Physicians Mail Requests to:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (202) 741-2404
Fax: (202) 741-2431

 

Insurance Mail Requests to:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (202) 741-2404
Fax: (202) 741-2431

 

Law Firm or Agent Mail Requests to:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (202) 741-2404
Fax: (202) 741-2431

 

For Other Requests or Inquiries:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (202) 741-2404
Fax: (202) 741-2431

 

The average turnaround times for requests are:

Request Type Processing Time
Patient 10-14 Business Days
Disability 14-30 Business Days
Legal 14-30 Business Days
Insurance 14-30 Business Days
Continuation of Care, Physicians Office, Clinics 10-14 Business Days

Thank you for trusting The GW Medical Faculty Associates with your health care.

Request Forms