Forms for Belton Regional Medical Center

Release of Information

In order to provide you with the most timely and efficient service, we have established the following procedure for releasing protected health information effective April 8, 2013.

Patients

Medical records requests are not processed on-site. When requesting copies of patient records including billing records please mail your request(s) to the address below, or call toll free 1-877-302-7338 for more info.

HCA Shared Services
Release Of Information
Boulders VIII
7300 Beaufont Springs Drive
Richmond, VA 23225

Health Care Providers

Medical records requests are not processed on-site. When requesting copies of patient records please include:

  • Name of facility in which you are requesting information
  • Patient Name/DOB/SSN if available
  • Specific dates of treatment/ specific reports or test results
  • Write STAT on the request

Either fax the patient authorization, or the above information on your fax cover sheet or office letterhead stationary to 1-855-237-6374 (toll free), or call 1-877-302-7338 (toll free).