Release of Medical Records
Pawnee Valley Community Hospital is happy to provide you with a copy of your medical record for follow-up care, insurance purposes or your own use.
To request a copy of your medical records, mail or bring a completed Authorization Form to:
Medical Records Department
Pawnee Valley Community Hospital
923 Carroll Ave.
Larned, KS 67550
Continuing Care – no charge if the records are sent directly to another care provider. Please enter the care provider’s name and address on the authorization form in Section 3.
Personal Use – Pages 1-10 are 50 cents per page, Pages 11+ are 25 cents per page.
Fee for electronic duplication (CD or email, etc.) of records – flat rate of $14.85
This new rate is effective 11/11/2017
Click the button below for the authorization form:
Release of Information