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  • Authorization For Release Of Information - Wvu Healthcare

Get Authorization For Release Of Information - Wvu Healthcare

Morgantown, WV 26506 CNST 614 (R 6/2014) Date: MRN CSN Authorization for Release of Information 1. Patient name (Last) (First) (Middle Initial) Address (City) (State) (Zip) Phone Birthdate SSN (to.

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A request for copies of medical records must be in writing, dated and signed by the person making the request, and include a reasonable description of the records sought. If someone is making a request on your behalf, he or she must provide evidence of the authority to receive the records (such as a power of attorney).

If produced in paper format: $20.00 search and handling fee. $0.50 per page for up to 50 pages. $0.25 a page thereafter.

If your records are in an online system, it may take up to 30 calendar days. If your records are on paper, it may take up to 60 calendar days. This usually applies to records created before 1998.

Most healthcare providers aim to respond to requests within three weeks. If you do not hear back within this time write again or call to request an update. If you have not heard anything after 40 days you can make a formal complaint.

The average minimum requirement is five years; however, some Medicare/Medicaid audits and/or actions can occur up to ten years after treatment and/or billing has occurred. Statutory or Regulatory Requirements: Several state and federal regulations and rules may affect medical record retention periods.

To obtain medical records, you may now request your records by using the records request tool, through MyWVUChart, email, mail, or calling 304-598-4110 (or toll free 844-484-0304).

The average minimum requirement is five years; however, some Medicare/Medicaid audits and/or actions can occur up to ten years after treatment and/or billing has occurred.

Patients have a right to obtain copies of their medical records under provisions of the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as West Virginia Code 16-29-1 and 16-29-2.

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© Copyright 1997-2025
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3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232