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Patient Resources Medical Records

Requesting Copies of Medical Records

  • To request a copy of your medical records, download the “Authorization to Use or Disclose Health Information” form available in English (link) or Spanish (link).
  • Print the form and fill out completely. Please be sure to sign and date to avoid delays in processing your request. If you are the health care agent, court-appointed guardian, holder of a medical power of attorney or other legally appointed representative, please attach proof of your authority to act on the patient’s behalf. 

To return the completed authorization form:

  • Take the form to the WellSpan Philhaven location in which you are receiving services
  • Mail, fax or deliver in person to:
    Release of Information
    912 S. George Street
    York, PA 17403-3700

    Fax: 717-812-8119

    Release of Information can be reached at (717) 851-6396 during normal business hours, Monday through Friday 8:00 AM–4:30 PM. Closed on major holidays.

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