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Request Medical Records

You may request medical records by completing the Authorization for Release below and submitting as directed. Additionally, we are pleased to announce that you may view your records through a secure portal known as MyCare.  Click here for information on MyCare and how to set up an account.

 

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 (below), 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.

Authorization for Release of Patient Information (pdf)

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: $42.54
11-60 pages: $1.43 per page
61-400 pages: $0.71 per page
More than 400 pages: $0.37 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: $64.81
Subsequent pages: $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.