Records Request

Medical Record Request Form-English

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Medical Record Request Form-Spanish

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Public Records Request Form

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Public Records Request

PLEASE NOTE:
There is no charge associated with requests of less than 40 pages of records.
If the volume of records exceeds the minimum number of pages, it is the policy of the Department to receive all costs associated with a public disclosure request prior to providing the documents.

We calculate the actual copying costs based on the following charges and notify you of the total after the requested records are identified.

Copying Fees: $0.25 each letter and legal sized documents (Pursuant to WAC 332-10-170)

For more information please contact lacijo@forkshospital.org

Tort Claim Form Packet

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Clallam County Hospital District #1 Tort Claim Form Packet

Please carefully read all the information in this packet before completing and presenting your Clallam County Hospital District #1 (CCHD#1) Tort Claim. Tort claims are subject to public disclosure pursuant to RCW 42.56.

PLEASE NOTE:

all documents received by the Risk Manager become the property of CCHD#1 and will not be returned. Please keep a copy for your records and do not send original attachments as they will not be returned.

For more information please contact deborah.dillon@forkshospital.org