Records Request
To obtain medical records from Medina Regional Hospital, patients or their representatives need to submit a completed authorization form. This form requires the patient's information, the recipient's information, the specific records requested, and the patient's signature. Same applies for patient’s and/or Legal Representative who walk-in or submit an online request. The completed form can often be submitted via mail or fax.
- Detailed Instruction for Authorization for Release of Health Information Form:
- Medina Regional Hospital:
To obtain a blank Authorization for Release of Health Information Form, contact the Health Information Management/Medical Records department(830)426-7801.
- Medina Regional Hospital:
- Complete the Form:
- Patient Information: Include your full name, date of birth, address, and other relevant identifying information.
- Recipient Information: Specify who should receive the records (yourself, another healthcare provider, etc.).
- Record Specifics: Clearly indicate the dates of service, the types of records you need (e.g., doctor's notes, test results, etc.), and any specific limitations on the release.
- Authorization: Sign and date the form and include any necessary documentation if you are a personal representative to include photo Identification Card (TXID/Driver’s License).
- Submit the Form:
- Mailing completed Authorization for Release of Health Information Form:
Medina Regional Hospital – Medical Records Department
3100 Avenue E
Hondo, TX 78861 - Faxing Completed Authorization for Release of Health Information Form:
Attention: Medical Records Department
Fax Number: (830)426-7473 - Processing Time: Be aware that processing requests can take time (e.g., 7-15business days).
- Fees: There may be a fee for processing the request, especially if you want the records mailed or for certain purposes (e.g., legal, insurance).
- Patient Portal: If you have access to a patient portal (like MyChart), you may be able to access some of your records there directly.
Link: https://medinahospitalportal.meditech.cloud
- Mailing completed Authorization for Release of Health Information Form:
