" " Request Medical Records | Bluegrass Community Hospital

Requesting a Copy of Your Medical Records

Bluegrass Community Hospitals takes patient privacy very seriously. We are committed to maintaining your medical records while keeping your health information private and secure in accordance with federal and state regulations. Requests must be processed through the Medical Records Department.

Hours: Monday to Friday, 8 a.m. to 4:30 p.m.
Phone: 859-879-2366 • Fax: 859-879-2453

To receive your own personal medical information from Bluegrass Community Hospital, you must:

  • Complete all sections of the Authorization for Release of Medical Information form (Click here to download and print). This form is also available from any clinical department, registration or Medical Records.
  • Hand-deliver, mail, or fax a signed request in writing to BGCH, Attn: Medical Records
  • Provide photo identification when records are picked up from the facility.
  • If you are under the age of 18, your parent or legal guardian must sign as well.
  • If someone other than yourself/guardian is going to receive/pick up the information you must name them as your personal representative on the form.
  • Your personal representative will need to provide photo id for verification.
  • Forms completed by Power of Attorney (POA) require a copy of POA paperwork.

Processing the record request may take 2-4 weeks depending on the size of the request. Copies will be sent to your home mailing address that you provided during registration unless otherwise agreed upon.

We will provide to the patient at no cost:

  • One copy of your medical records that are relevant to your care for your personal use.  If you want additional copies, you will need to specify which portion(s) and fees will be incurred and billed to you by the Copy Vendor.
  • There is no cost to you or delay in processing when your medical records are sent directly to your medical care provider and insurance carriers.
  • These requirements include copies of reports or film from the Radiology Department.
  • When copies of film(s) are requested for your personal use there will be a charge for the disc processing. There is no charge for discs sent directly to your medical care provider.  
  • Walk in request for immediate pick up is not possible due to processing time and safety checks that are required to protect your Health Information.  Please make arrangements with the Medical Records department in advance.

Revocation of Release

You have the right to take back (revoke) your authorization to release of your medical records. To do this you must put your request in writing.  That can be mailed it to:

Bluegrass Community Hospital
Attn:  Health Information Management
360 Amsden Avenue
Versailles, KY 40383

If you have any questions please call the Release of Information Department at 859-879-2366.

Revoking this authorization will not affect any actions that Bluegrass Community Hospital may have already taken based on the authorization. Also, if the authorization was a condition for getting insurance, revoking it does not affect the insurer’s right to contest a claim made under the policy, or the policy itself.

When you release your medical information, whoever receives it may share it (except for any notes about drug or alcohol use and psychotherapy notes) with someone else. In this case, the information may no longer be protected by the HIPAA/Privacy Rule.

Treatment cannot be withheld or based on getting this authorization.