Medical Records

Releasing Medical Records

A patient (or his/her legal representative) may inspect and/or obtain a copy, or have copies of medical records sent to another facility. There may be a charge for this service. Patients may limit the request to specific information to include discharge summary, operative/procedure report(s), implant information, emergency report(s), radiology reports, labs, consults, medication administration information, progress notes, etc. Please note that if you need radiology films or CD's, you will have to contact Radiology directly at 724-983-5656.

Sharon Regional Medical Center requires a completed and signed written request or authorization form for release of protected health information before releasing any documents to anyone, including the patient. Identity must be verified by photo ID. No medical record information or results can be provided verbally in person or over the phone.

Obtaining Copies of Your Medical Records Release of Information (ROI)

Records can be released to anyone that the patient authorizes (in writing, along with photo ID). A valid authorization MUST be fully completed, dated, and signed or the request will be returned.

Forms completed by Power of Attorney (POA) require a copy of POA paperwork. Medical records may be requested by a competent patient if the patient is 18 years of age or has been emancipated.

Medical records of a deceased patient may be requested by the personal representative of the patient's estate. If the deceased does not have a personal representative, his or her spouse may make a request. If there is no spouse, a child of the deceased patient (or the parent, guardian, or custodian of the child if the child is incompetent) may make a request. Verify death by providing a copy of the death certificate. All requests will be reviewed to determine the identity of the requestor.

Request a Copy of Your Medical Records

Print and complete the medical record request form.

English Form

Spanish Form

The form must be completed, dated, and signed. Photo identification must be provided.

We ask that you specify what components of the medical records you wish to obtain. Often, the discharge summary, operative report, and history and physical contain relevant information to suit your needs. This will help to keep the cost down, and allow the patient the specific information that they require.

If you have any questions regarding release of health information, please call (724) 983-3835 or submit our contact form below.

Contact Us

To submit your request once your form is completed:

Mail form to:

Sharon Regional Medical Center
Attn: Release of Information
740 East State Street
Sharon, PA 16146

OR Fax form to:

Attention: Release of Information

OR Bring form to:

Sharon Regional Medical Center Health Information Management (Medical Records)
740 East State Street
Sharon, PA 16146
Hours: Monday-Friday, 8:00 a.m. - 4:30 p.m.

If you have any questions regarding release of health information, please call (724) 983-3835.