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VA Northern Indiana Health Care System


Request Your Medical Records

 Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

  • access to your medical records
  • obtaining copies of your medical records
  • requests to amend your medical records
  • completion of forms for benefits, insurance, and other reasons

The Release of Information Staff is expert in our patients' rights and their medical records.
The Release of Information Office at the Fort Wayne Campus is located in the main hospital building, 1st floor, room 175.  The Marion office is located in building 138, basement level, room 018.

How to Request Information

To request a medical record, please use one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to one of the following addresses —

VA Northern Indiana Health Care System
Business Office  Release of Information
2121 Lake Avenue  Fort Wayne  IN  46805
800-360-8387 71909

VA Northern Indiana Health Care System
Business Office  Release of Information
1700 E 38th Street  Marion  IN  46953
800-360-8387 73436

Because forms must contain an original signature, forms cannot be accepted by e-mail.
Requests for records will take approximately 1-20 days to process. (note:  Our goal is to complete requests within 5 working days for an electronic record request and 20 working days for non-electronic records.


There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, photocopying fees may be assessed.


Health Information Management
Release of Information
800-360-8387 Ext. 71909