If you have received or are currently receiving services with Region Ten Community Services Board, you are entitled to access your records, and share information about your services as you see fit. Records will be available to pick up at 500 Old Lynchburg road during normal business hours or be mailed within 14 business days of the request.
Region Ten Community Services Board cannot release any information about people receiving services unless a Signed Authorization is in place allowing that exchange of information. If you have questions about or would like assistance completing this form, you may contact Medical Records team at 434-970-1470.
Instructions for accessing CSB medical records are also available in Spanish, along with a Spanish version of the authorization form.
Requesting your records in person:
Fill out the Authorization For Release of Health Information form or the Medical Records Request form and bring it to our 500 Old Lynchburg Road location during normal business hours. A member of the Medical Records team will then review the form for completeness and adherence to federal, state and local regulations. They may contact you for additional information.
To ask about obtaining your records outside of the hours listed, please call 434-970-1470 and leave a message with a phone number for staff to return your call.
Requesting your records via US mail:
Fill out the Authorization For Release of Health Information form or the Consumer’s Personal Records Request and mail to:
Region Ten Community Services Board
Attention: Medical Records
500 Old Lynchburg Road
Charlottesville, VA 22903
Requests for medical records may also be sent via fax to the Medical Records team at Region Ten at 434-972-1864
To request medical records via email please send a message to firstname.lastname@example.org
Your medical records can also be requested by other agencies. Region Ten Community Services Board will only release your medical records to such groups if you have a current signed and dated Authorization For Release of Health Information form that meets the requirements of 42 CFR, Part 2 and HIPAA regulations and the requirements of the Region Ten CSB Medical Records policy and procedure.