Health Information Management – Medical Records
The Health Information Management (HIM) Department of Appalachian Regional Healthcare System (ARHS) is dedicated to the practice of acquiring, analyzing and protecting medical information vital to providing quality patient care.
You have privacy rights under a federal law that protects your health information. These rights are important for you to know. Federal law sets rules and limits on who can look at and receive your health information. Click for more information about our privacy practices.
Forms: Authorization for Disclosure of Protected Health Information
Copies of Medical Records
Patients who need a copy of their Medical Record must complete the Authorization for Use or Disclosure of Protected Health Information form (linked below). Form must be completed in its entirety.
- ARHS Authorization For Disclosure Of Protected Health Information (0.5 MiB)
- ARMA Authorization For Disclosure Of Protected Health Information (0.8 MiB)
- 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.
Appalachian Regional Healthcare System contracts with CiOX Health to handle the release of medical information. Please bring check, debit/credit card, or money order for payment. We do not accept cash payment.
Fees/charges will comply with all laws and regulations applicable to release of information.
Hours of Operation:
- The Foley Center, Cannon, and Watauga: Monday – Friday 8:00 am – 4:15 pm
- Appalachian Regional Medical Associates (ARMA) releases should be completed through ARMA provider; hours are based on offices’ operating hours. Click here for a full list of offices.
Release of Information from Appalachian Regional Healthcare System (ARHS)
ARHS Facilities: Watauga Medical Center (WMC), The Cardiology Center, Seby B. Jones Cancer Center, Wound Care Center, Cannon Memorial Hospital (CMH), The Foley Center at Chestnut Ridge.
HIPPA Authorization for Use or disclosure of Protected Health Information – ARHS Return the form in person, by mail, or fax to the HIM department at the facility you received treatment from. See contact info/addresses on form.
|The Foley Center at Chestnut Ridge (828) 386-3268 FAX: (828) 386-3269||Cannon Memorial Hospital (828) 737-7547FAX: (828) 737-7531||Watauga Medical Center (828) 262-9581 FAX: (828)265-5014|
Release of Information from Appalachian Regional Medical Associates (ARMA)
HIPAA Authorization for Use or Disclosure of Protected Health Information – ARMA: Return the form to the ARMA Medical Office you received your treatment from via fax, mail, or in person. Click here for a full list of offices.
Appalachian Regional Medical Associates (828) 737-7413