PO Box 334 Sandston, VA 23150 Raymond J. Alderfer, MD

As of March 31, 2022, I closed my practice.

To obtain records please contact Raymond J Alderfer, M.D., PO Box 334 Sandston, VA 23150 or email: Telald110@gmail.com. A response can be expected within 30 days.

Here are three options for you to get your healthcare records:

  1. Your new healthcare provider may request your records on your behalf
  2. You may request records to be sent to a provider
  3. You may request that records be sent to you

Option 1) Your healthcare provider can request your records. If your healthcare provider requests your records their contact information will be included in their request form. You will sign a consent form at your healthcare provider's office that will authorize the release of records. You will not need to send a separate consent form to me. The form from the healthcare provider is all that is needed.

Option 2) If you request that your records be sent to a healthcare provider you will need to provide the information on the authorization form so that I can verify that the provider is a licensed medical entity. A form titled Authorization to Release Confidential Medical Records can be downloaded from this website for that purpose. You can send your completed form by mail or email.

Option 3) You can request that your records be released to you. For your protection, I require notarization of the authorization form. A form entitled Authorization to Release Confidential Medical Records to Self can be downloaded. You can send your completed form by mail or by email. Your banking institution may offer notary services. You may also search google to find a notary.

Fees: While there is no charge for providing records to another provider, there may be a charge, as determined by Virginia law, for requests for records faxed or mailed to patients.

Raymond J. Alderfer

Raymond J. Alderfer, MD

© 2022 Raymond J Alderfer, M.D., PO Box 334 Sandston, VA 23150. Email: Telald110@gmail.com