The Medical Records Department at Refugio County Memorial Hospital is committed to the secure maintenance of your medical records while upholding the utmost privacy of your health information.

Your Medical Records: Copies of medical records may
be requested for yourself, a minor child, or an individual for whom you hold legal guardianship or possess a Durable Power of Attorney for Healthcare. Proof of legal guardianship or a Durable Power of Attorney for Healthcare is mandatory for access to these records.

To obtain copies of your medical records, kindly complete the Authorization for Disclosure/Inspection of Protected Health Information form, available for download in PDF format.

Completed forms can be submitted in one of two ways:

• Delivered in person to the Medical Records Director at Refugio County Memorial Hospital.
• Mailed to the following address:

Refugio County Memorial Hospital
Attention: Medical Records Department
107 Swift St.
Refugio TX, 78377

Upon processing your request, you may collect the copies of
your records either in person or choose to have them mailed to your home address. If you opt for in-person retrieval, please bring photo identification.

For the release of records to a representative listed under the “Released To” section on the authorization form, the representative must provide a copy of your photo identification.

For reasons of confidentiality, we are unable to send medical records via email or fax to your home or office. Please be aware that there may be associated fees for records, and we will notify you before dispatching them.

Should you require assistance, please reach out to our Medical Records Department at 361-526-2321 ext. 201, 211, 213 during our regular business hours, which are Monday through Friday from 8:00 AM to 5:00 PM

For requests pertaining to X-Ray, CT, or MRI images, kindly contact the Radiology Department at 361-526-2321 ext. 222.

To obtain a copy of your Bill or Itemized Statement, please contact our Business Office at 361-526-2321 ext. 101.