Looking to Obtain a Copy of Your Medical Records?
Paper Copy of Medical Records:
Federal HIPAA laws require an authorization to be completed for all medical record requests, unless your provider is requesting them for your care. Your medical record, and the information it contains, is confidential. Therefore, we must confirm your identity before releasing your medical record. Only the patient or his/her legal guardian can sign the form. You can download the authorization form below:
Release of Information Form:
To obtain your medical record, please bring all of the documents listed below with you to the Medical Records department at West Valley Medical Center. We are available to accept medical records requests between the hours of 8:00 am and 4:30 pm Monday thru Friday. You can also fax the request forms with a legible copy of your ID to our toll-free fax number at 877-865-9738.
- Authorization for Use and Disclosure of PHI Form Completed and signed
- A current government issued photo ID (passport, driver’s license, State ID, or military ID)
- Power of attorney for healthcare paperwork if the patients POA is requesting records.
Please be aware that it may take up to 30 days to receive your records.
Records for your Physician
Our goal is to get your health information to the appropriate health care provider as quickly as possible; therefore we recommend that your physician (or other healthcare provider) request a copy of your medical records to be delivered directly to his/her office by fax. There is no charge to you for this service.
Nashville Health Information Management Service Center (HSC)
Release of Information
PO Box 290429, Nashville Tennessee 37229
Read more about our responsibilities and your rights for privacy.