Maryland Law specifies that a request for any patient medical record must be in writing and must become a part of the person's medical record. The medical records department protects the confidentiality of all patient information and will only release a patient's medical record with the proper consent.

If a physician involved in your care needs a copy of your medical record, the medical records department can forward a copy to that physician with your consent. For purposes other than treatment, requests for copies of records are handled on a case by case basis utilizing state and federal guidelines for the proper release of patient information.

Your Medical Information & Privacy

FMH Notice of Patient Privacy

Release of Medical Records

To request the release of medical records, either for a patient’s own use or for transfer to another healthcare provider, the patient (or their legal representative) must provide authorization by submitting a signed copy of the Authorization to Release Medical Information Form.

To request a copy of an X-ray (diagnostic study), patient must provide authorization by submitting a signed copy of the Authorization to Release Diagnostic Images Form. Directions on how to complete the form.

Email requests cannot be accepted. A fax copy of the authorization form can be accepted. Photo ID of the patient or legal representative must be presented at the time of pick-up.

Send the request to the appropriate address below:

Health Information Management Frederick Memorial Healthcare System 400 West Seventh Street Frederick, MD 21701 Phone: 240-566-3444 Fax: 240-566-3634

Radiology Department Frederick Memorial Healthcare System 400 West Seventh Street Frederick, MD 21701  Phone: 240-566-3420 Fax: 240-566-3255