This form is used to certify the authenticity of medical records provided to the attorney by a medical provider.
Kentucky Certificate of Authenticity of Medical Records
State:
Multi-State
Control #:
US-PI-0013
Format:
Word;
Rich Text
Instant download
Description
How to fill out Certificate Of Authenticity Of Medical Records?
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FAQ
Providers and Hospitals: Medical records shall be retained for at least six (6) years from date of discharge, or three (3) years after the patient reaches the age of majority under state law, whichever is the longest.
Example, if your provider maintains paper medical records, they own and have the right to keep the original record, but you have the right to see and get a copy of it.
Medical records shall be retained for at least six (6) years from date of discharge, or three (3) years after the patient reaches the age of majority under state law, whichever is the longest.
You may submit a letter identifying the records sought or complete and submit a Division of Health Care - Open Records Request Form. Please be sure to provide your name, address and daytime telephone number in the event we need to contact you. All requests for records must be signed by the requester.
You may submit a letter identifying the records sought or complete and submit a Division of Health Care - Open Records Request Form. Please be sure to provide your name, address and daytime telephone number in the event we need to contact you. All requests for records must be signed by the requester.
(1) Upon a patient's written request, a hospital licensed under KRS Chapter 216B or a health care provider shall provide, without charge to the patient, a copy of the patient's medical record.
