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Request Medical Records
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Request Medical Records
Because an actual signature is required to release medical records information, personnel at Texas Health Rockwall are not allowed to process requests or authorizations received via e-mail. Please download the Authorization for Release of Patient Information, complete all required fields, sign it, and mail the form to the Health Information Management (Medical Records) Department. Mailing Address for Texas Health Rockwall is 3150 Horizon Rd, Rockwall, Texas 75032. You may also fax the completed authorization to 469-698-1751.
Fees
The Texas Legislature sets the fees our hospital charges for copies of medical records. This is found in S241.154(e) of the Health and Safety Code. These charges are reviewed and updated annually based on the price index as published by the Bureau of Labor Statistics of the United States Department of Labor. The following fees are effective at Texas Health Rockwall as of January 1, 2009:
Medical Records In Paper Form
Texas Health Rockwall charges the following fees for the copying of health care information. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.
1-10 pages:

11-60 pages:

61-400 pages:

More than 400 pages:
$42.54

$1.43 per page

71¢ per page

37¢ per page
Records Stored On Other Medium
If the requested records are stored on any microform or other electronic medium, the hospital charges the following fees. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.
1-10 pages:

Subsequent pages:
$64.81

$1.43 per page
Exceptions
Local, state or federal agencies requesting health care information may be entitled by statute to a different fee. The agency should inform the hospital of this fact, or information can be obtained from the Legal Department.
Other Charges
The hospital may charge a reasonable fee for:
• Execution of an affidavit or certification of a document, not to exceed the charge authorized by Section 22.004, Civil Practice and Remedies Code; and
• Written responses to a written set of questions, not to exceed $14.40 for a set.
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Addresses
Main Hospital
3150 Horizon Road
Rockwall, TX 75032
(469) 698-1000
Full-Service Emergency Room
2265 N Lakeshore Dr.
Rockwall, TX 75087
(972) 216-8300
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