LewisGale Regional Health System utilizes a vendor, CIOX Health, for release of information.
You may request the release of your medical records by printing and completing the following form:
- Authorization for Release of Protected Health Information
- Instructions for completing the authorization form
Upon completion, choose one of the following options:
- Fax the completed form to:
CIOX Health - (855) 330-4290
- Mail the completed form to:
Release of Information
Richmond Shared Service Center
7300 Beaufont Springs Drive
Richmond, VA 23225
Allow five to seven business days for processing.
Records to be released to another medical office for continuation of care are sent at no cost. Please specify the medical office name, address, phone and fax in the “Recipient” section of the authorization form.
There is a charge for personal requests for your medical records, which is $0.25 per page for paper copies and $0.02 per page for electronic copies. Your records will be mailed to the recipient address or email provided on the authorization form. The records will be mailed from CIOX Health and the envelope will display their logo.
For questions, please contact CIOX Health Customer Service at: (877) 302-7338.