Release of Health Information Procedures

Please read the following document because it pertains to the release of health information:

• Release of Health Information Procedures (PDF)

Current Medical Record Request

To request medical records for a patient, please fill out the following form:

• authorization-single-to-release-information-for-him use-hand-writeable-version;(PDF)

Please send the completed form to:

Southwestern Virginia Mental Health Institute
Attn: Health Information Management Department
340 Bagley Circle
Marion, VA 24354

We will get back in touch with you as soon as possible.

Micro Films

To obtain records on micro film, please fill out the following form:

• Microfilm Request Form

Please send the completed form to:

Southwestern Virginia Mental Health Institute
Attn: Health Information Management Department
340 Bagley Circle
Marion, VA 24354

We will get back in touch with you as soon as possible.

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