Medical Records Authorization Form
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To receive copies of health information, the hospital must have a valid authorization signed by the patient or his/her legal representative. Once the authorization form is completed, it may be mailed to Owensboro Medical Health System, P.O. Box 20007, Owensboro, KY  42304, or faxed to (270) 688-3197.

Office hours for our Health Information Management (Medical Records) Office are 8 a.m.- 5 p.m. Monday through Friday.

Download the Form  (Adobe PDF)