Medical Records
To request a copy of medical records for care received at Hoosier Therapist, please follow the directions below.
To request a copy of medical records for care received at Hoosier Therapist, please complete a release of information (request one by emailing teale@hoosier-therapist.com).
Please return a completed release of information by mail, e-mail or fax to:
Attention: Hoosier Therapist
Address: 9783 E 116th St PMB 6234 Fishers, IN 46037
E-mail: teale@hoosier-therapist.com
Fax: 317-886-4574
The following fees apply to process your request. You will receive an invoice along with your records.
Produced/Requested Medium and Cost
Cost for delivery in electronic format (CD, USB, download or portal).
$6.50 flat fee for labor OR $20 flat fee for labor if records require formatting or retrieval work
Plus cost of supplies (CD, USB, etc.)
Cost for record delivered on paper.
$20 flat fee for labor
Plus cost of supplies: $1.00/page for pages 1-10 (not applied if labor fee is applied); $0.50/page for pages 11-50; and $0.25/page for pages 51+
Additional Fees
Postage, if mailed.
Certification fee of $20, if records need to be certified
This process is in compliance with federal HIPAA guidelines. Please allow up to 30 business days for your records to be processed and mailed to your specified address.
Who is authorized to request release of medical records?
The patient, if not a minor. For patients under age 18, a parent or parents may sign.
The patient’s health care representative or Power of Attorney, if the patient is unable to sign – legal documents must be provided.
Legal guardian if appropriate – documentation must be provided.
Executor of an estate. For deceased patients, the executor of the estate is the first person who can request copies of records. Death certificates and estate documents must be presented.
For more information, please contact Teale Rutledge Annen at 317-207-6037 or teale@hoosier-therapist.com.