Medical Records Requests

Welcome to the INOV8 Orthopedics Medical Records Info Page

If you would like to request medical records, please follow the guidelines below:

FMLA (Family Medical Leave Act) REQUESTS:

  • Complete Request for Form Completion
  • Complete FMLA form (patient portion) from your employer
  • Send $25.00 payment with both forms to:
    • INOV8 Medical Records
      10496 Katy Freeway, Ste 101
      Houston, Texas 77043
    • OR Fax to 713.492.2440
  • Forms take 7-10 business days to complete once forms and pre-payment are received. We will contact you to coordinate a designated date & time to pick up records.
    • Emergency requests without fee will only be made if another healthcare provider or physician requests for purposes of emergency or acute medical care.

Disability Requests:

  • Complete Request for Form Completion form
  • INOV8 will administer fees per the Texas Health & Safety Code 161.202.
    • No charge for the medical health record requested by a patient or former patient if the request is related to a benefits or assistance claim based on the patient's disability.
    • Fees will apply for the medical record of a patient or former patient requested by a state or federal agency in relation to the patient or former patient's application for benefits or assistance; or an appeal relating to
  • Complete Disability form (patient portion)
  • If applicable, send $25.00 payment with both forms to:
    • INOV8 Medical Records
      10496 Katy Freeway, Ste 101
      Houston, Texas 77043
    • OR Fax to 713.492.2440
  • Forms take 7-10 business days to complete once forms and pre-payment are received. We will contact you to coordinate a designated date & time to pick up records.
    • Emergency requests without fee will only be made if another healthcare provider or physician requests for purposes of emergency or acute medical care.

X-Ray Requests:

  • Complete the Authorization for Use/Disclosure of Protected Health Information Form (all parts of the form must be completed)
  • Radiology / Imaging Section - please specify the DATE of the X-ray.
  • Send total of $14.70 ($8.00 payment and $6.70 for current USPS charge as of 2/1/18) with the form to:
    • INOV8 Medical Records
      10496 Katy Freeway, Ste 101
      Houston, Texas 77043
    • OR Fax to 713.492.2440
  • X-ray CDs take 7-10 business days once form and pre-payment is received. We will contact you to coordinate a designated date & time to pick up CD if not being mailed.
    • Emergency requests without fee will only be made if another healthcare provider or physician requests for purposes of emergency or acute medical care.

Medical Records Requests:

  • Complete Authorization for Use/Disclosure of Protected Health Information Form (all parts of the form must be completed)
  • For TRANSFER of RECORDS to another physician, there is no charge for copies.
    • Send form to INOV8 Medical Records
      10496 Katy Freeway, Ste 101
      Houston, Texas 77043
    • OR Fax to 713.492.2440
  • For COPIES of RECORDS for all other purposes, for paper copies, the charge is $25 for the first twenty pages and $.50 per page for every copy thereafter. Electronic copies are $25 for 500 pages or less.
  • Send form and payment to:
    • INOV8 Medical Records
      10496 Katy Freeway, Ste 101
      Houston, Texas 77043
    • OR Fax to 713.492.2440
  • Affidavit charge shall be $15.00 whether by paper, electronic or hybrid format.
  • $6.70 postage fee applies for CD’s and records 10+ pages (current USPS charge as of 2/1/18)
  • Medical Records Requests take 7-10 business days once form and pre-payment is received. We will contact you to coordinate a designated date & time to pick up records.
    • Emergency requests without fee will only be made if another healthcare provider or physician requests for purposes of emergency or acute medical care.

We welcome you to visit our Patient Portal to submit any questions about the status of your Forms, X-Ray and Records Requests.

Already Signed up for The Portal? If you are already registered and signed up for the portal, please visit the hyperlink to simply enter your information and security questions. You will then be able to access your online health record.

Go to Messages and send a Message to your Care Team to ask for the status.


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