Medical Records Requests

All medical records requests require a payment of $30 for patients and $100 for insurance companies/attorneys. Payments are accepted in the form of cash or check.

Make all checks payable to:
Urologic Surgeons of Washington
1147 20th St NW, Suite 400
Washington D.C. 20036

Requests must be accompanied by a signed medical records release form which can be filled out below. All requests must be submitted online. Processing of medical records will only begin upon receipt of payment. Please allow 7-10 business days for processing.

Medical Records Release Form