Medical Records

Need to request copies of medical records? Discover the information you need to process your request today!

Authorization for Release of Medical Information

PMC works with an outside source to coordinate providing copies of medical records to patients and/or authorized people. To process a request to obtain copies of medical records, follow one of the following options:

  • Please contact our Medical Records Department at 570-476-3388 to request the Medical Records Release form to be sent to you
  • Download a PDF  of the Medical Records Release form, complete it and send to PMC at 206 East Brown Street, East Stroudsburg, PA 18301, or by fax at 570-476-3709.

    PMC works with an outside service to process medical records requests. Fees for processing a medical record are as follows, effective January 1, 2002:

    Requestor

    Copy Charges

    Patient Representatives, Lawyers

    $18.54 search and retrieval fee
    $1.20/page (1-20 pages)
    $ .93/page (21-60 pages)
    $ .31/page (61 + pages)
    $1.83/page (microfilm copies)
    +actual postage

    Patients

    $1.20/page (1-20 pages)
    $ .93/page (21-60 pages)
    $ .31/page (61 + pages)
    $1.83/page (microfilm copies)
    +actual postage

    District Attorney

    $18.54 basic charge + actual postage

    Disability Determination - PA

    $23.49 basic charge only

    Social Security Disability Benefits Request

    $23.49 basic charge + actual postage

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