Release of Medical Information

Bates County Memorial Hospital (BCMH) complies with the Health Insurance Portability and Accountability Act (HIPAA) regulations concerning release of protected health information. Upon request by the patient for medical information (medical records), the Health Information Management (HIM) Department can provide the patient’s medical records if a signed release has been obtained with proper identification verified.

Authorization forms may be mailed or delivered in person to the HIM Department. Records cannot be released until identification has been verified.

The HIM office is open Monday through Friday, from 8 a.m. to 4:30 p.m. (CST). For questions regarding your medical records, please call during regular business hours.

BCMH may charge a fee to copy the requested health information. The fee will be based on the cost of the labor and supplies involved in copying the requested health information and the postage for mailing the copies.

BCMH responds to requests for health information within 30 days of our receipt of your request. If we require additional time to respond to your request, we will contact you to inform you of this extension of time.

Please send requests for medical records to:

Bates County Memorial Hospital
615 West Nursery St.
Butler, MO  64730
Phone: (660) 200-7000 ext. 7622 or 7625

Attention: Health Information Management

Download the Authorization for Release of Protected Health Information (Medical Records).