Reqest for Medical Records
To request a copy of your medical records from Princeton Community Hospital, you will need to complete our “Access Request Form.” For a printable three-page PDF Access Request Form, please use this link.
Reqest for Amendment to Medical Records
If you believe an error was made in the documentation on your record, please complete the “Request for Amendment of Protected Health Information (PHI) Form” and return it by either faxing to 304-487-7549, e-mailing to firstname.lastname@example.org, mailing to Princeton Community Hospital, P.O. Box 1369, Princeton, WV 24740, or by coming to the Medical Records Department at PCH, Monday – Friday, 8:00 a.m. to 4:30 p.m. Please use the link below to download and print the three-page “Request for Amendment Form.” You do not need to fill out the third page. That is for PCH use only. Once we receive your completed form, your request will be reviewed by the author of your health information.
Our Health Information Management (Medical Records) Department will be closed temporarily to the public.
To obtain your medical records, you may:
1. Use our Patient Portal. Call 304-487-7521 or 304-487-7257 for Portal assistance.
2. Visit us at www.pchonline.org and print an authorization for release of medical records and mail/fax/email to us.
3. Obtain an authorization for release of medical records at the front door or at Patient Access Department (Registration). Complete and return to us by mail, fax or email.
4. Email us at ROI@pchonline.org
5. Call us at 304-487-7257 or 304-487-7521 to discuss obtaining your medical records.