Medical Record Copy Fees (Pennsylvania)

In accordance with Pennsylvania state law, reasonable fees may apply for copies of your medical records.

  • $1.89 per page for pages 1–20
  • $1.40 per page for pages 21–60
  • $0.49 per page for pages 61 and higher

Postage and applicable sales tax may be charged if records are mailed. There is no fee when records are sent directly to another healthcare provider for continuing care.

Fees are subject to periodic adjustment by the Commonwealth of Pennsylvania. If you have questions about costs, please contact our office before submitting your request.

Medical Records Request

Medical Records Request

Use this secure form to request copies of your medical records such as office visit notes, imaging reports, operative reports, or billing summaries. Typical processing time is 7–10 business days. Fees may apply per state and federal regulations.

Patient Information
Records Requested

Leave dates blank to request all available dates of service.

Delivery Method
Who should receive the records?
Authorization & Signature
HIPAA Authorization: I authorize Argires Marotti Neurosurgical Associates of Lancaster to use or disclose my protected health information as requested above. I understand this authorization is voluntary and I may revoke it in writing at any time. I acknowledge that information disclosed to a third party may not be protected by HIPAA. This authorization will expire 1 year from the date signed unless I specify an earlier date below.