How to Request Medical Records
Option 1: Request records from Clinical Support Services
Please email Kena Pickett or Charlene Green.
Option 2: Request medical records by mail
To request a copy of your medical records, download the forms below and mail them to the appropriate facility. Please be advised there may be a cost involved for this service.
Authorization to Use Form
Treatment and Financial Agreement
Mail completed form along with copy of photo ID to:
Hampton University Proton Cancer Institute
40 Enterprise Parkway
Hampton, VA 23666