For questions, call (606) 218-3505 or email ROI@pikevillehospital.org
Due to our facility’s visitation restrictions and to ensure the safety and well-being of our patients, their families, and staff during the coronavirus (COVID-19) state of emergency, the Medical Records office is temporarily closed. If you need medical records, please follow these steps:
- Complete the AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION form (click here to download/open a PDF of the form)
- 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, death certificate, executor of estate, or next of kin affidavit.
- 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
911 Bypass Road
Pikeville, KY 41501
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) 218-3505.