Patients request a copy of their records for many reasons. Whether you
need it for personal reference, or to transfer care to a physician’s
office, we are here to help. Patients requesting their own records
must sign a release form, either in person or by fax (see fee schedule below). A physician’s
office requesting medical records must fax the request to the number listed
below on their office letterhead.
Charge Policy: The following charges are applicable at each request based
on Indiana 760 IAC 1-71-3. Payments shall be collected prior to copying
and releasing records.
- A labor fee of $10.00
- $1.00 per page for the first 10 pages
- $0.50 per page for pages 11-50
- $0.25 per page for pages 51 and higher
- Actual cost of mailing the records
- Additional $10.00 if the request is for copies to be provided within two
- $20.00 for certifying a patient’s medical records
Treatment*, Payments, and/or Operational requests are excluded from copying fees.
- The charges shall apply, but are not limited to, the following requests:
- Patient requesting their own records
- Attorney requests
- Disability requests
Phone: (812) 825-0905
Fax: (812) 825-0784