Request a Copy of Your Medical Records

To begin your request, simply download and print a copy of this form:

Authorization for Release of Health Information

• Be sure to fill it out completely, including signing and dating it.  Incomplete forms may be returned to you for completion.
• No information can be released unless the form is properly signed and dated.
• If you are the healthcare agent, court appointed guardian, holder of a medical power of attorney or similar legally appointed representative, please attach proof of your authority to act on behalf of the patient.

Return the completed form (and any attachments) via fax, in person or by mail to the address below:

Fax #: 410-502-5186.

Mailing Address:
Johns Hopkins Hospital
600 North Wolfe Street
Health Information Management
Phipps Building, Room B150
Baltimore, MD 21287

Hours:
We are open 8 a.m. to 5 p.m., Monday through Friday and closed on weekends and national holidays.

Fees

There is a fee for copying medical records. 

 $0.76 per page copy charge
 $22.88 preparation charge (This fee is not charged to patients.)

This is no charge for records sent directly to a physician or healthcare facility for continuing care.

The fees will be in compliance with applicable Maryland State guidelines.