Fairfax-Falls Church Community Services Board

Fairfax County, Virginia

CONTACT INFORMATION: Emergency - 703-573-5679 Detox - 703-502-7000 (24/7)

703-383-8500
TTY 711

8221 Willow Oaks Corporate Drive
Fairfax, Virginia 22031

Daryl Washington,
Executive Director

Requesting your CSB medical record

If you have received or are currently receiving services with the Fairfax-Falls Church Community Services Board, you are entitled to access your records, and share information about your services as needed.

Records will be available to pick up or be mailed within 15 (fifteen) business days. We are not able to transmit records via email.

The CSB cannot release any information about people receiving services unless a signed Authorization to Disclose or Request Protected Health Information form is in place allowing that exchange of information.

Request your record in person

Fill out the Authorization to Disclose or Request Protected Health Information form and bring to one of the following CSB locations:

  • Merrifield Center, 8221 Willow Oaks Corporate Drive, Fairfax
    7 a.m. to 6 p.m.
  • Gartlan Center, 8119 Holland Road, Alexandria
    8 a.m. to 4:30 p.m.
  • Chantilly Center, 14150 Parkeast Circle, Suite 200, Chantilly
    8 a.m. to 4:30 p.m.
  • Northwest Center, 1850 Cameron Glen Drive, Suite 600, Reston
    8 a.m. to 4:30 p.m.
  • Pennino Building, 12011 Government Center Parkway, Suite 300, Fairfax
    8 a.m. to 4:30 p.m.

A records technician will review the form for completeness and adherence to federal, state and local regulations, and may ask for additional information.

To submit a request in person outside of the hours listed, please call 703-383-8480 to schedule an appointment.

Request your record via US mail

Fill out the Authorization to Disclose or Request Protected Health Information form and mail to:

Merrifield Center
Attn: CSB Records
8221 Willow Oaks Corporate Drive
Fairfax VA 22031-4512

A records technician will reach out if additional information is needed.

Request your record via fax

Fill out the Authorization to Disclose or Request Protected Health Information form and fax to 703-653-6685. A records technician will reach out if additional information is needed.

At the time your records are released, a payment of $0.37 cents per page up to 50 (fifty) pages and $0.18 cents per page thereafter, or $6.00 for a CD, plus a $10.00 administrative fee will be collected to cover the costs associated with copying and researching your record.

If you have any questions regarding your CSB Medical Record, please call 703-383-8480.