Medical Records Request

How to obtain a copy of your medical record

Patients who have received care at Lake Norman Regional Medical Center may request copies of their medical record/health information by completing an “Authorization for Release, Use and Disclosure of Health Records” form.

Download the Authorization for Release, Use and Disclosure of Health Records »

The form must include a telephone number where the patient can be reached. Also, a copy of the patient's driver's license or a photo ID must be returned with the completed form. 

Your completed form, along with a copy of your photo ID, may be submitted below or by email:  Deidrem@statisllc.com or fax:  (704) 660-4038 or mail it to: 

Deidre Moore
Attn: Medical Records
Lake Norman Regional Medical Center
PO Box 3250
Mooresville, NC  28117

The Health Information Management Department, formerly known as Medical Records, is open Monday – Friday, 8:30 a.m. – 4:30 p.m. Turn around time for requests is five business days and the fees are as follows:

  • 1-25 pages $0.75 per page
  • 26-100 pages $0.50 per page
  • 101 plus pages $0.25 per page, not inlcuding postage

There is no charge for copies that go to physicians or other hospitals.


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