Valley Health Medical Record Release Forms

Medical Record Release Forms

Valley Health Systems keeps a private, secure medical record about your health. To authorize others to view and manage your medical records, or to authorize Valley Health to obtain your medical records from another institution, complete the appropriate form below and return to Valley Health. Here is how you can submit your completed form:

  • Upload the form to the My Valley Health Patient Portal
  • Fax an electronic copy the form to our Business Office at 304-399-3236
  • Mail a hard copy of the form to Valley Health Medical Records C/O Business Office at PO Box 1680, Huntington, WV  25717
  • Email the form to Medical Records by sending to [email protected]

*Due to the nature of email security, we cannot guarantee that patient's information is secure if you chose to use the email option.

General Medical Release Form

Behavioral Health Release Form 

{credit}

Find a Valley Health Location Near You

We have 30+ locations to better serve you in your town.