Records Request

Medical Record Request Form-English

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Medical Record Request Form-Spanish

Thumbnail image of Records Request form to download as PDFClick to download

Medical Records Request

Mail To:

Forks Community Hospital
Medical Records Department
530 Bogachiel Way
Forks, WA 98331

Fax to:

360-374-5616

Email to:

kerstinh@forkshospital.org

Deliver to Health Information Management:

Monday – Friday, 8:00am – 4:30pm

We are unable to accept forms with electronic signatures. Please give us 3-5 working days to respond to your request.

For more information, please call: 360-327-8311
MyFCHHealth Patient Portal Enrollment Form

Click to download

Permission Form for MyFCHHealth Portal Proxy

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Patient Portal

Mail To:

Forks Community Hospital
Medical Records Department
530 Bogachiel Way
Forks, WA 98331

Fax to:

360-374-5616

Email to:

kerstinh@forkshospital.org

Deliver to Health Information Management:

Monday – Friday, 8:00am – 4:30pm

All of the information in the Portal comes from your Forks Community Hospital Electronic Health Record. This ensures that you have access to the most accurate, up-to-date information possible.

 

All of Your Information in One Place

  • Health Information
    • Lab Results
    • Radiology Reports
    • Visit History
    • Discharge Instructions
    • Health Summary
  • Appointments
    • Upcoming Visits

  • Allergies and Medications
    • Allergies and Conditions
    • Immunizations
    • Medications with Instructions
  • Billing
    • Outstanding Balances
    • Historical Charges and Statements

For more information, please call: 360-327-8311
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

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