Medical Records

Medical Record

Please follow these steps to obtain your medical records:

    You may complete an AD-66 (form to access medical records) by printing the authorization and mailing the completed form.
    Knox Community Hospital
    ATTN: Medical Records
    1330 Coshocton Road
    Mount Vernon Ohio 43050
    We will send your records immediately upon request.
  2. For walk-in clients only the AD-66 form is available in the Medical Records department, or print and complete prior to your visit.
  3. You may access our patient portal (Follow My Health) to view and manage your personal health information.  To set-up an account at call Portal Support at 740.399.3777.
  4. Submit an online request for records to be mailed or sent to your provider.
  5. Fees and postage may apply.

We sincerely appreciate your cooperation and understanding.

Your Health Information Management Team

Medical Records

Monday - Friday 8 AM - 4:30 PM
Closed Weekends and Holidays

Fax: 740.399.3113

AD-66-Authorization for Use or Disclosure