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Health Information Management

To Receive Your Medical Records:


Before the hospital can release medical records, an Authorization to Release Information form must be signed by the patient or his/her legal representative outlining specifically what is to be released and to whom. If the patient is under the age of 18, a parent may sign for a copy of the records in most circumstances. An authorization is valid for 6 months and must be completed each time records are requested.

The Authorization to Release Information form can be obtained by:

  • Visiting the Health Information Management department between 8:00 a.m. and 4:00 p.m., Monday through Friday.
  • Requesting that the form be mailed to you by calling 304-329-3220.
  • Downloading the form and instructions here.

Please complete the form in its entirety for applicable areas.

For questions, please call 304-329-3220 Monday through Friday, 8 am-4:30 pm, excluding holidays.

You can return the form to HIM (Medical Records) by:

    150 Memorial Drive

    Kingwood, WV  26537

We make every effort to provide your medical information as quickly as possible.  By law, your request will be fulfilled within 30 days. Please try to request your information several days before you need your records.



Contact Information

HIM Department

304-329-3220

FAX: 304-329-2822

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