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How to Obtain a Copy of Your Medical Record

Patients who need a copy of their Medical Record must complete the Authorization for Use or Disclosure of Protected Health Information form. These forms are located at the links below, specified per location. Form must be completed in its entirety.

Patients 18 years of age or older must sign for themselves - includes married partners.
Emancipated minors must sign for themselves.
A copy of the patient's driver's license or picture ID is preferred. Please include a copy of the photo ID with this form.

Once the form is completed in its entirety for services provided at:
Watauga Medical Center
Fax: 828-265-5014... or mail to:
Health Information Management
336 Deerfield Road
Boone, NC 28607
Questions: Call 828-262-9581

HIPAA Authorization for Use or Disclosure of Protected Heatlh Information - Watauga Medical Center

Cannon Memorial Hospital
Fax:· 828-737-7531... or mail to:
Mail: Cannon Memorial Hospital
Health Information Management
434 Hospital Drive
Linville, NC 28646
Questions: 828-737-7543 press 3

HIPAA Authorization for Use or Disclosure of Protected Health Information - Cannon Memorial Hospital

Blowing Rock Rehabilitation & Davant Extended Care Center
Fax: 828-295-4587... or mail to:
Mail: Blowing Rock Rehabilitation & Davant Extended Care Center
Health Information Management
PO Box 148
Blowing Rock, NC 28605
Questions: 828-295-2566

HIPAA Authorization for Use or Disclosure of Protected Health Information - Blowing Rock Rehabilitation & Davant Extended Care Center


Please come to the Health Information Management Department (formerly known as Medical Records) between the hours of  8 am to 4:15 pm, Monday through Friday.

Appalachian Regional Healthcare System contracts with IOD to handle the release of medical information. The fees are as follows

  • First 3 pages are complimentary
  • .39 per page
  • There is no charge for copies that go to physicians or other hospitals.