Request Your Medical Records

To receive a copy of your medical record, print out and complete our authorization form and mail or fax it to the facility or hospital listed below. If you have further questions about your medical records or health information please contact the phone number listed for the facility where your service was provided.

Mailing Address:

Sentara Martha Jefferson Hospital
HIMS Department
Attn: Release of Information
500 Martha Jefferson Drive, Mail Stop #G276
Charlottesville, VA 22911

Phone: 434-654-7650434-654-7650
Fax: 757-938-5751


Monday - Friday, 8 a.m. - 5 p.m.