With the current COVID-19 restrictions, the process for requesting a copy of your medical records is as follows:
Complete an authorization to release records
To receive an authorization:
- Download the medical records request form and print the form
- Call Health Information Management (HIM) at 270-825-5256 to request an authorization, which will be faxed or mailed to you.
Complete the authorization, including address or fax number where the records need to be sent and include the signature of the patient.
Return the form by:
- Mail: Attention: Medical Records, 900 Hospital Drive, Madisonville KY 42431
- Fax: 270-825-5942 Attention: Medical Records
If you are taking the medical records to a physician’s office, have them call and request the records. HIM can fax the records directly to the physician’s office.
HIM will be answering phones during the hours from 8 AM to 4 PM, Monday through Friday. Please call 270-825-5256 with any questions.
Please do not come to the hospital to request medical records.
*We apologize for the inconvenience, but due to the need for a signature, we cannot accept any e-mailed copies of this form.