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The Medical Records Department is now open at its new location:

 

Medical Records
126 Healthcare Drive
1st Floor
Pikeville, KY  41501

 

This location is across from Speedway.

 

 

Required Documents

 

  • Complete the AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION form (click here to download/open a PDF of the form)thumbnail of Medical Record Request Form #413
  • Include a copy of a government issued photo ID.
  • If you are the patient’s representative requesting records on behalf of the patient or if the patient is deceased, documentation authorizing the release of the records to you is required.

Acceptable documents includes a court order, power of attorney, or executor of estate.

  • If you elect to have your medical records released to any other person/entity, please provide that information in Section 6 of the Authorization

Mail the completed form, copy of ID, and supporting documents to:

 

Pikeville Medical Center
Attn: Medical Records Department
126 Healthcare Drive
1st Floor
Pikeville, KY  41501

            Or

By FAX: (606) 218-4855

            Or

By Email: ROI@pikevillehospital.org

 

Continuing Care Requests

 

To have records sent to a physician, please provide the physician’s office information, including the

Physician’s name and fax number in Section 6 of the Authorization. There is no charge to send records to your physician.

 

If you have questions, please contact us at (606) 430-3800.

 

Pikeville Medical Center