OrthoVirginia (Richmond) patients please complete the following forms as needed or as directed by your physician:
- MRI Screening Form
- Authorization for Release of Medical Records TO OrthoVirginia
- Authorization for Release of Medical Records FROM OrthoVirginia
To request your medical records from OrthoVirginia, please complete the authorization form above and either mail or fax to listed information below.
We do use the services of BACTES to process our medical records request. There is also a charge for release of information.
Per Code of VA § 8.01-413 applies
- Pages 1-50 = $ 0.50 each page
- Pages 51 & above = 0.25 each page
Plus all postage and handling cost.
Any questions about your request or invoice can be answered by calling BACTES Imaging at (877) 270-4365
Forward request to:
Attn: Medical Records Dept.
1115 Boulders Parkway, Suite 200
North Chesterfield, VA 23225
Fax: (804) 330-2439