Requests for copies of your medical record and/or films will be processed upon receipt of proper written instructions and authorization, per federal and state requirements. There is a medical records processing fee required at the time of request which is based on the volume of records and urgency of request. Please allow 14-30 days from the date of your request for our staff to complete its processing. Urgent requests will be treated as such.
Medical Records Release Form
Patients may download a copy of our formatted medical records release form below. Patients should complete the form in its entirety including: which specific medical records are needed, the recipient of the records (name, complete address, and phone number), and the purpose of the request to avoid any processing delays. Requests must then be mailed or faxed to our office Attention: Medical Records OR emailed to medicalrecords@foxhall.com.
Inactivated Charts (older than 2003)
Please note, if your chart has been inactivated (older than 2003), an additional retrieval fee will apply. Charts are only retrieved from our off site storage facility at the beginning of each month. Special arrangements can be made by contacting our medical records secretary and will be handled on a case by case basis.
Questions regarding the form or records release process should be directed to our medical records secretary by calling the main office number (202) 895-1440 or by email at medicalrecords@foxhall.com.
Request Records be sent TO Foxhall Surgical Assoc., P.C.
We have also created a form you may use to request records be sent from your current doctor's office TO Foxhall Surgical Associates, P.C. for your upcoming appointment with our physicians. Please remember, you should contact your doctor's office to find out their policies and procedures for making a medical records request including time frame and associated fees. We prefer our patients bring all the necessary records to the office at the time of consultation. However, records may be mailed or sent by fax.
Women's Center for Breast Diagnosis
Update 6/1/08: All patients who have not yet arranged for transfer of their Women's Center mammogram films will now be charged a $35 processing fee.Due to the closure of our screening mammogram facility February 28, 2007, mammogram films will no longer be stored in our facility. Patients should arrange for the transfer of all previous mammogram films as soon as possible. A copy of the Women's Center closure notice which was mailed to our mammography patients in December 2006-January 2007 can be found below.
Patients of the Women's Center for Breast Diagnosis will need to locate a new facility for their next mammogram. Our physicians recommend patients have a Digital mammogram at Sibley Breast Center. Please call (202) 537.4545 to schedule an appointment. There are several other local facilities that also utilize digital technology.
Some tips to make this transition easier for our patients:
Determine when your last mammogram was performed. Please note that some insurance companies have timing requirements for coverage of mammograms, you will need to contact your insurance company to verify coverage.
You will be scheduling either a Digital Screening or Digital Diagnostic mammogram. This is based on your personal and family history and risk factors. Your physician will determine which type of mammogram is appropriate. All mammograms performed at our Women's Center were routine Screening mammograms. If you had your last mammogram here and no new breast complaints have be noted in the past year, it is likely that you will continue to have Digital Screening mammograms. Please do not hesitate to contact our office if you have any new symptoms or complaints or if you are unsure what type of mammogram is appropriate. Please see the Breast Health Guidelines section of this site for additional recommendations.
You will need an order for your mammogram. The provider who overseas your breast health should write your mammogram order (or prescription). If you are a patient of Foxhall Surgical Associates, P.C. and you intend to continue following up with our surgeons for your annual physical breast exam, we are happy to provide you with an order. Please note on your written film transfer request that you would like an order included with your films. You will need to contact our office to make a follow up breast exam appointment with our physician.
Request your mammogram films. Submit a written request for the transfer of your films to our office. You may download and complete our standard medical records form above and either mail or fax it to our office. Your request should include: the date and location of your next mammogram appointment and if you need an order from one of our doctors (you must make an appointment with our doctor before we can write your order). Please also call the office to confirm receipt of the request.
Due to a high volume of transfers, requests must be made a MINIMUM of 30 days prior to your next mammogram appointment. Transfer of records due to the closure is free of charge; however, you may incur a fee if: the request was made with less than 30 days notice, the request is for an inactivated chart (older than 2003), or special mailing/handling fees apply. Please call our office to ensure the request has been received by our medical records department.
Former Patients of Ronald Kurstin, M.D.
Due to the sudden passing of Dr. Ronald Kurstin in August 2006, all medical records from his practice have been transferred to the care of Foxhall Surgical Associates, P.C.. The records are currently located in our off-site storage facility and can be retrieved and provided to patients upon receipt of a medical records request. Patients should download and complete the standard medical records form above and submit it to the medical records secretary who will then contact you with additional information regarding fees for this service.