Option #1 – Submit Your Request Online
Option #2 – Submit Your Request via PDF
To complete a physical request form, download, print, and fill out the appropriate PDF below.
Brandywine Hospital Patient PDF Forms
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Medical Records PDF Request[PDF]
Print and fill out this form to request a copy of your medical records from Brandywine Hospital.
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Solicitud de Registros Médicos[PDF]
Imprima y complete este formulario para solicitar una copia de sus registros médicos al Hospital Brandywine.
Tower Health Medical Group Patient PDF Forms
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THMG Medical Records Request[PDF]
Print and fill out this form to request a copy of your medical records from Tower Health Medical Group. -
Solicitud de registros médicos de THMG[PDF]
Imprima y complete este formulario para solicitar una copia de sus registros médicos a Tower Health Medical Group.
After you complete a PDF request form, submit your completed form in one of two ways:
- By fax: 484-628-9777
- By mail:
Brandywine Health Information Management
PO Box 16052
Reading, PA 19612-6052
Additional Information
Processing time for medical records and radiology studies is approximately five to seven business days. Radiology films must be returned within 30 days.
- Request forms must be signed by patients 18 years of age and older.
- Official birth certificates are available only through the Pennsylvania Department of Health.