How to Request Medical Records
To obtain a copy of your medical records, you will need to complete the following form: Download The Request Medical Records Form Please read the Form Instructions carefully to avoid any delays in getting your medical records:
- Download Request Medical Records Form complete, sign and date it. Be sure to have it signed by a Witness.
- In order to validate your authorization, please provide a legible copy of a valid photo I.D (e.g., driver’s license, military I. D. or state I.D.).
- Please indicate the dates of services for which you are requesting.
- Please indicate the type of records needed.
- If the patient is a minor, 17 years or younger, the request must be signed by a parent or his/her legally qualified representative. Proof of legal representation will be required.
1. Mail it or deliver it in person to the medical records department at
Houston Physicians’ Hospital
Attn: Medical Records
333 N. Texas Ave, Ste 1000
Webster, Texas 77598
2. Or fax it to: 281-557-5687
3. You may scan your signed forms and valid photo ID to:
If you have any questions, please call the medical records department at 281-557-5678.