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Medical Record Requests

Please complete the appropriate form below to fulfill your request. If you have any questions, please reach out to our Medical Records Team at 717-761-0930 and we will be happy to assist you.

Medical Record Requests

Please complete the appropriate form below to fulfill your request. If you have any questions, please reach out to our Medical Records Team at 717-761-0930 and we will be happy to assist you.

Request Medical Records

Complete this form to authorize your provider or healthcare team to send your medical records to JSG.

Release Medical Records

Complete the form below to authorize JSG to release your medical records to your provider or healthcare team.

(717) 761-0930

West Shore – Main Campus:

423 North 21st Street,
Camp Hill, PA 17011

East Shore:

4387 Sturbridge Drive,
Harrisburg, PA 17110