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Requests for Medical Records
Because an actual signature is required to release medical records information, personnel at Presbyterian Hospital are not allowed to process requests or authorizations received via e-mail. Please download the Authorization for Release of Patient Information, complete all required fields, sign it, and mail the form to the Health Information Management (Medical Records) Department. Mailing Address for Presbyterian Hospital of Rockwall is 3150 Horizon Rd, Rockwall, Texas 75032. 
 

Authorization for Release of Patient Information, click on the image below:

Fees
The Texas Legislature sets the fees our hospital charges for copies of medical records. This is found in S241.154(e) of the Health and Safety Code. These charges are reviewed and updated annually based on the price index as published by the Bureau of Labor Statistics of the United States Department of Labor. The following fees are effective at Presbyterian Hospital of Rockwall as of January 1, 2009:

 
Medical Records in Paper Form
Presbyterian Hospital of Rockwall charges the following fees for the copying of health care information. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.
 
 1-10 pages:   
 $42.54
 11-60 pages:   
 $1.43 per page
 61-400 pages:   
 $0.71 per page
 More than 400 pages:  
 $0.37 per page
 
Records Stored on Other Medium
If the requested records are stored on any microform or other electronic medium, the hospital charges the following fees. Additionally, the hospital charges the actual cost of mailing, shipping or otherwise delivering the provided copies.
 
1-10 pages:
 $64.81
Subsequent pages: 
 $1.43 per page
 
Exceptions
Local, state or federal agencies requesting health care information may be entitled by statute to a different fee. The agency should inform the hospital of this fact, or information can be obtained from the Legal Department.
 

Other Charges

The hospital may charge a reasonable fee for:

  1. Execution of an affidavit or certification of a document, not to exceed the charge authorized by Section 22.004, Civil Practice and Remedies Code; and
  2. Written responses to a written set of questions, not to exceed $14.40 for a set.