This website will be unavailable after July 31, 2024. Information on this website is not being maintained and may not be current.

Effective July 31, 2024, resources on RTA will be transitioning to and the MMRIA SharePoint Site. RTA will no longer be responding to technical assistant requests nor updating state profile pages as of May 15, 2024. Please contact if you have any questions. 

Texas Medical Records Request Form – Hospital

Fax Cover sheet and Records Request letter sent to hospitals in which the patient in question may have received services, including labor and delivery, postpartum, emergency department, outpatient labs or imaging, behavioral health or substance use treatment, and allied health services.
Year of publication and/or last update:
Texas Department of State Health Services
Resource Type Tags:
Review Stage Tags:
Case Abstraction
Case Identification
Case Selection
Role Tags:
Case Abstractor