Medical Record Request and Authorization

Request Indiana Hospital Records by Mail

A printable PDF request form is available for download to request medical records for Norton Clark Hospital, Norton Scott Hospital or Norton King’s Daughters’ Hospital.

Download, print and complete the form, then submit the request via mail to the hospital.

Online Portals for Norton Clark Hospital, Norton Scott Hospital or Norton King’s Daughters’ Health

Norton Healthcare Kentucky Hospitals Medical Record Request and Authorization

Obtaining your personal health information is your right. Norton Healthcare is simplifying this process by allowing you to submit your request online.

Release of Information Form

Click on Complete Request below to submit an online release of information authorization. Once submitted, your request will be processed within 14 business days. Patient requests will be released to the patient’s Norton MyChart account if an active account is available.

Submit Documentation – Patient Request Completed Above

Supporting documentation may be indicated at the time of your request for release of medical information. You may now submit this required documentation online and a Health Information Management associate will verify and process the documents.

If you are unable to complete your request online, you can submit a form via MyNortonChart, click on the Form below or call (502) 629-8766 and ask that a form be mailed to you. All records will be mailed or submitted to you via Norton MyChart.

Submit Documentation

If you are the patient’s attorney or insurance representative and have an authorization form completed by the patient please feel free to upload both your request letter and copy of the signed authorization form here. Please ensure to include any necessary documentation such as Executor/Personal Representative paperwork for a deceased patient or POA paperwork if applicable.

Contact Us

Health Information Management associates can be reached between the hours of 8 a.m. and 5 p.m., Monday through Friday, at (502) 629-8766 or via email at RequestStatus@nortonhealthcare.org. Please allow up to two business days for e-mail response.

Health Information Management
N16 P.O. Box 35070
Louisville, KY 40232-5070

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