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.

YOU MAY REQUEST YOUR RECORDS BE MAILED BACK TO YOU OR FEEL FREE TO ARRANGE TO PICK THEM UP FROM THE ADDRESS ABOVE. HOWEVER, TO ENSURE PATIENT PRIVACY MEDICAL RECORDS WILL NOT BE FAXED.

Physicians Mail Requests to:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (703) 302-1141
Fax: (202) 741-2431

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

Law Firm or Agent Mail Requests to:
3811 North Fairfax Dr., Suite 1000
Arlington, VA 22203
Phone: (703) 302-1144
Fax: (202) 741-2431

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

The average turnaround times for requests are:

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

Request Forms

• Authorization to Release Protected Health Information
• Authorization for Disclosure or Access of Protected Health Information