Medical Records

Electronically:

For your convenience, you can complete the Authorization to Release Medical Records Form electronically by clicking the button below.*

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You can download a printable version of the form here. This version may be submitted one of the following ways below.*

 

*Please note: In order to complete your request, we would like a copy of your picture ID with any request for medical records. If we do not have proper custody or healthcare power of attorney paperwork on file, we will need that with your request as well. You can email a photo of the document to medical-records@mvhealthcenters.org or text an image to 740-891-9000 with a note that says ATTN: Medical Records.

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Mail:

Mail your completed Medical Record Request Form to:

MVHC Medical Records

2725 Pinkerton Lane

Zanesville, OH 43701

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In Person:

If you would like to submit your form in person, you can drop off your completed form to any of our MVHC locations. If you would like assistance filling out your form, you can visit MVHC South Zanesville and ask to see one of the Medical Records Team Members. MVHC South Zanesville is located at 2725 Pinkerton Lane, Zanesville, Ohio. 

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Fax:

Your completed Medical Record Request Form can be faxed to 740-891-9002.

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Email:

Your completed Medical Record Request Form can be emailed to medical-records@mvhealthcenters.org.