Request Your Medical Records - VA Northern Indiana Health Care System
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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 —

Fort Wayne campus:

VA Northern Indiana Health Care System
Attn: ROI Department
2121 Lake Avenue,
Fort Wayne, IN 46805

Suzie McIntyer, ROI Specialist
Phone: 1-800-360-8387, extension 71909
Fax: 260-460-1352

Marion campus:

VA Northern Indiana Health Care System
Attn: ROI Department
1700 E 38th Street,
Marion, IN 46953
 
Amanda Masters, ROI Specialist
Phone: 1-800-360-8387, extension 73902
Fax: 765-677-3131

Jerald Tinkle, ROI Specialist
Phone: 1-800-360-8387, extension 73436
Fax: 765-677-3131

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.

Fees

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.

Contact

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