Medical Records

The Medical Records Department will be happy to provide you or your healthcare provider copies of your medical record. Your medical record contains information regarding your personal health and the care that took place at Valley West Community Hospital.

In order to assure confidentiality and to comply with the law, we may need you to sign an authorization for release of your health information. A copy of this authorization is available below or it can be obtained from our office. A nominal fee may be charged in order to obtain your records.

Medical Records Release
Medical Records Release - Spanish

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Notice to patients requesting medical records

We are happy to accommodate you in providing copies of your medical records. In order to process your request we require the following:

• Name and date of birth of the patient
  
• Signed authorization from the patient allowing release of records
  • If the patient is unable to sign valid proof of Power of Attorney, guardianship or Executorship must be presented
  • For minors under 18 years of age the parent or guardian must sign
  
• Specific dates of service and reports requested
  
• The purpose of the request and the person/facility to whom the information is to be released
  
• Picture ID presented at the time of record pick-up
  
• A nominal fee may be charged in order to obtain your records
  
• Fourteen-day processing time for purposes other than continuing care

If you have any questions regarding your medical records, please call (815) 786-3741.