During the COVID-19 issues, the Annex will remain open the regular business hours (Mon – Fri) 8 am – 4:30 pm. We do require anyone entering the building to wear a mask and only one patient within our lobby at a time. If you are not comfortable with coming into our office, you can either download the release form below or call us at 812-825-0905 and we will mail you the release form with instructions.
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, and provide a photo identification either in person or by fax. A physician’s office requesting medical records must fax the request to the number listed below on their office letterhead with the patient’s name, date of birth and what information they are requesting.
- 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 working days
- $20.00 for certifying a patient’s medical records
Treatment, Payments, and/or Operational requests are excluded from copying fees.
- The charges may apply, but are not limited to the following requests:
- Patient requesting their own records
- Attorney requests
- Disability requests