Brandywine Hospital Forms
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Patient Request for Information[PDF]
To request a copy of your Brandywine Hospital medical records, download this form.
Next Steps
Submit your completed form in one of three ways:
- In person:
Brandywine Hospital
201 Reeceville Rd.
Coatesville, PA 19320
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By fax: 610-383-8543
- By mail:
Brandywine Hospital
Attention: Health Information Management
201 Reeceville Rd.
Coatesville, PA 19320
Additional Information
Processing time for medical records and radiology studies is approximately five to seven business days. Radiology films must be returned within 30 days.
- Photo ID is required for pickup.
- Request forms must be signed by patients 18 years of age and older.
- If picking up records for someone else, you must bring your photo ID and a note signed by the patient stating that you are permitted to retrieve the records.
- Official birth certificates are available only through the Pennsylvania Department of Health.