United States Department of Veterans Affairs

Providence VA Medical Center, Rhode Island

Release of Information

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
  • Notary Public Stamps
  • In-Person Authentication to My HealtheVet

The Release of Information Staff is expert in our patients' rights and their health records.

The Release of Information Office is located in the basement of the Ambulatory Care Building in Room D011. You may reach us by phone at (401) 273-7100 ext. 3481, 3482, and 3485.  Business hours are 8:00 am to 4:30 pm Monday through Friday.

How to Request Information

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

Providence VA Medical Center
Health Information Management Section (HIMS)
830 Chalkstone Avenue
Providence, RI 02908

Because forms must contain an original signature, e-mailed or faxed forms cannot be accepted.

Requests for records will take approximately 10 days to process.

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.


Patient Information

Patient Information
Eligibility
Make, Change, or Cancel an Appointment 
Customer Service 
Release of Information 

Release of Information Forms

pdf document Request for and Authorization to Release Medical Records or Health Information (VA 10-5345) 
pdf document Individuals' Request for a Copy of Their Own Health Information (VA 10-5345a) 

Related Links

Notice of Privacy Practices