Keep up to date with access to your medical files:
Request Copies of Medical Records
Copies of your medical records can be sent to your physician or to another hospital without charge. If you are a patient (or a patient’s personal representative) and would like access to your medical records, please complete the “Request for Access to Protected Health Information” form. For patient requests needed form West Tennessee Medical Group, please contact the clinic directly. If you have questions, please call and speak with the Health Information Management Department of the facility you are requesting records from. Jackson-Madison County General Hospital’s number is 731-541-7982, and the office is open Monday-Friday, 8:00 a.m. – 4:30 p.m. Closed Saturday, Sunday, and Holidays.
The “Authorization for Release of Protected Health Information” form is also attached, but it is only used if a third party is requesting a patient’s records and the patient does not initiate this request. (For instance, if an attorney requests copies of records.)
Online Request for Medical Records For HOSPITAL records only, please contact CLINICS directly for CLINIC records.
Request for Access to Protected Health Information
Spanish – Request for Access to Protected Health Information
Authorization for Release of Protected Health Information
Spanish – Authorization for Release of Protected Health Information
Continuation of Care Fax: 731-541-6768
| Facility | Call | Fax |
| Bolivar General Hospital | 17316590231 | 17316590271 |
| Camden General Hospital | 17315936174 | 17315936129 |
| Humboldt Medical | 17317840392 | 17317840398 |
| Jackson-Madison County General Hospital | 17315417982 | 17315416955 |
| Milan General Hospital | 17317231348 | 17317233361 |
| Volunteer Hospital | 17315883250 | 17315418259 |
| Dyersburg Hospital | 17312884733 | 17312872171 |
| Henry County Hospital | 17316448432 | 17316448566 |
NONDISCRIMINATION NOTICE STATEMENT
West Tennessee Healthcare (WTH) does not exclude, deny benefits to, or otherwise discriminate against
any person on the grounds of race, color, national origin, age, religion, disability, Limited
English Proficiency or sex, including discrimination based on gender identity, sexual orientation,
sex stereotyping or pregnancy in admission to, participation in, or receipt of the services and
benefits under any of its programs and activities, whether carried out by WTH directly or through a
contractor or any other entity with which WTH arranges to carry out its programs and activities.
For further information about this policy, contact Amy Garner (731) 541-9914.
