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    Medical Records

    We strive to make it as easy as possible for you to obtain a copy of your medical record. Please note that in compliance with state and federal laws, all requests must be submitted in writing, form be completely filled out and signed with a witness signature.

    How to request your medical record On the form you will indicate which records to be released (Lab, Radiology, Emergency Room, Respiratory, Walk-In Clinic, etc.) and how we should release the records. Please allow up to 14 days for the request to be processed.
    The first copy of a record is free, but additional copies thereafter has a charge of $1.00 per page. However, if records are being sent to another physician, the fee will be waived.
    Submit the Form
    The completed and signed form may be mailed, faxed, or delivered to:

    Livingston Hospital
    Attn:  Health Information Management Services Department
    111 E Main St.
    Salem, KY 42078
    270-988-7233 or 270-988-7250 
    Fax: 270-988-4327