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Forms

How to Obtain Your Medical Records in Response to COVID-19

As part of our commitment to the health care of the community, as well as the safety of patients and employees, Pleasant Valley Hospital (PVH) has implemented a process on how patients may obtain a copy of their medical records in response to Coronavirus Disease 2019 (COVID-19). The process became effective Monday, March 30, 2020.

To acquire a copy of your medical records, simply follow the steps below:

  1. Complete a disclosure of health information authorization form. This form is form available at the hospital front desk located at the main entrance of the hospital and on the hospital website here.
  2. Upon completion of the authorization form, return it a representative at the front desk or mail it to:


    Pleasant Valley Hospital
    Medical Records, Release of Information
    2520 Valley Drive
    Point Pleasant, WV 25550

If you have any questions or require additional information, please call 304.675.4340, ext. 1355. Representatives available to help you Monday through Friday from 7:30 a.m. to 3:30 p.m.

Authorization Form for Disclosure of Protected Health Information (pdf)

Mason County Schools On-Site Healthcare Consent Form (pdf)

2020-2021 Sports Physical Form (pdf)

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Pleasant Valley Hospital
2520 Valley Drive
Point Pleasant, WV
304.675.4340

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