Release of Information / Record Requests
Written authorization is required for medical records from Holly Hill Hospital and must be submitted to the Health Information Management (HIM) Department.
The timeframe for request once it is received by Holly Hill Hospital HIM Department will be dependent on several factors:
- availability of records
- volume and age of records requested
- requested format
- additional approvals needed
Medical records are typically mailed.
Requesting Medical Records
How to Request Medical Records
- Download the HIPAA complaint HIM authorization form using the link below. Once you have completed the form – must be signed (no typed signatures), must have a valid full mailing address, if requesting as legal guardian/guardian ad litem/POA a copy of the legal papers must be included with the request, choose one of the following to send it to Holly Hill Hospital HIM:
- Record Authorization/Release Form
- Fax to: 919-250-7075
- Mail to: Holly Hill Hospital, HIM Dept., 3019 Falstaff Road, Raleigh, NC 27610
- Drop-off at Holly Hill Hospital Reception (any one of the facilities: Main, Children’s, or South)
- Timeframe: from Holly Hill HIM receiving a completed compliant authorization, standard release may take 30-days or more. All requests will be processed as timely as possible.
If you have questions, please call: 919-250-7228
HIM is open Monday through Friday, 8:30A.M. – 4:00P.M excluding Holidays. We are available to answer any questions you may have on completing the release form or any general release of information questions.