Your Medical Records

At GANV, patients can be assured their medical records are protected and secured. Our goal is to provide exceptional and prompt services to our patients and other health care professionals in regards to the maintenance, and transferring of all protected health care information.

Health information is the data related to a person’s medical history, including: symptoms, diagnoses, procedures, and outcomes. Health information records include patient histories, lab results, x-rays, clinical information, and notes. A patient’s health information can be viewed individually, to see how a patient’s health has changed.

The Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.

Access

  • Only you or your personal representative has the right to access your records.
  • A health care provider may send copies of your records to another provider only as needed for treatment or payment or with your permission. 
  • The Privacy Rule does not require the health care provider to share information with other providers or plans.
  • HIPAA gives you important rights to access your medical record and to keep your information private.

Charges

  • A provider cannot deny you a copy of your records because you have not paid for the services you have received. 
  • However, a provider may charge for the reasonable costs for copying and mailing the records. The provider cannot charge you a fee for searching for or retrieving your records.

Corrections

  • If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record. The health care provider must respond to your request. If it created the information, it must amend inaccurate or incomplete information. 
  • If the provider does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.

Make a Request

To receive a copy of your medical record, print out and complete our authorization form below and mail or fax it to the contact information below

All patient health care information at GANV is confidential. Therefore, medical records cannot be released to any person without the authorization of the patient or the patient's legal representative, unless mandated by court order.

Written Authorization

All requests for the release of medical records must be submitted in writing through the use of a GANV authorization form, and must be dated and signed by the patient or the patient's legally authorized representative. In the case of a minor, the parent or guardian must sign the authorization.

Submitting a Request for Medical Records From GANV

Submit a written authorization for the release of medical records from GANV.

Processing fees have been established for copies of patient medical records/medical information and are subject to change. No fee is assessed when the information is being sent to another health care provider.

Complete the following forms:

Mail or Fax the completed forms to:

GANV 
Medical Records Department 
3028 Javier Road, 5th floor 
Fairfax, VA 22031 
Fax: 571-494-5794

  • E-mail requests or authorizations will not be accepted.
  • If the request is an emergency request for medical information for continuing patient care, fax the completed authorization to 703-641-8427.

Submitting Medical Records to GANV

To submit records to GANV from your physician’s office or hospital facility, please mail and or fax the Request for Medical Records Release to GANV.

Mail or Fax the completed form to:

GANV 
Medical Records Department 
3028 Javier Road, 5th floor 
Fairfax, VA 22031 
Fax: 571-494-5794

  • E-mail requests or authorizations will not be accepted.
  • If the request is an emergency request for medical information for continuing patient care, fax the completed authorization to 703-204-0980.

The Health Information Portability and Accountability Act (HIPAA)

Gastroenterology Associates of Northern Virginia –HIPAA Joint Privacy Notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.