Pineville Community Health Center is committed to protecting your health information and requires specific written information from you in order to release your medical record.

If you are looking for your medical record as it relates to a past stay at PCHC or one of our clinics, information about how to obtain copies of your medical records is provided below.

Simply download and complete the release form with filling out the form sending in photo ID. Please follow the instructions provided on this website (Step 1.). Return it to the appropriate location listed on this website (Step 2.). We will securely transfer your medical record according to your authorization as quickly as possible.


Copies of Medical Records Are Available for:

● Adult patients accessing their own medical records
● Parent or legal guardian accessing for their minor child will need to send in copies of power of attorney with the request.

Your Rights Regarding Your Medical Records

The federal privacy regulations give you many rights regarding your medical records. They include:

● The right to an accounting of certain disclosures of your medical information in the six years prior to the date of your request.

● The right to inspect and obtain a copy of your medical information.

● The right to receive confidential communications of your medical information by an alternative location.

● The right to submit a complaint to this hospital about how your medical information is used or disclosed.

Amy Lee, Health Information Director
606-337-3051, option 3 (phone)
606-654-2613 (fax)