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814-723-3300
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HomePatients/VisitorsMedical Records

Medical Records

Attached to the right are the General and Behavioral Health (BH/DA) patient Authorization forms for the Use and Disclosure of Protected Health Information (PHI).

Click on the reports to the right to open and print the forms.

  • Authorization for Warren General Hospital to use or disclose your protected health information to other entities
  • Authorization for other entities to disclose your protected health information to Warren General Hospital 
  • Behavioral Health/Drug and Alcohol Authorization for other entities to disclose your protected health information to Warren General Hospital
  • Behavioral Health/Drug and Alcohol Authorization for Warren General Hospital to use or disclose your protected health information to other entities

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Two Crescent Park West, Warren PA 16365

(814) 723-3300

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  • Home
  • About
    • History and Today
    • Living in Warren County PA
    • Vision for Future
    • Board of Directors
    • Executive Staff
    • Donate
    • Volunteering
    • Auxiliary
    • Contact Us
  • Specialties/Services
    • Behavioral Health
    • Cancer Care
    • Detoxification
    • Diabetes and Nutrition
    • Digestive Disease
    • Emergency and Hospitalist Care
    • Eye Care
    • Family Medicine
    • General Surgery
    • Home Alert
    • Hospital Home Care
    • Imaging
    • Internal Medicine
    • Laboratory
    • Maternity
    • Medical / Medical Surgery
    • Nursing
    • Obstetrics and Gynecology
    • Orthopedics
    • Pain Management
    • Pediatrics
    • Podiatry
    • Pharmacy
    • RehabWorks
    • Respiratory Care
    • Sleep Lab
    • Sports Medicine
    • Surgical Services
    • Swing Bed
    • Urology
    • Walk In Care
    • Women's Care
    • Wound Clinic
  • Education/Events
    • Community Calendar
    • American Cancer Society
    • Support Groups
    • Dare to C.A.R.E
  • Patients/Visitors
    • Life Sustaining Treatments
    • Financial Assistance
    • Patient's Rights, Responsibilities and Privacy Notice
    • Patient Responsibilities
    • Privacy Notice
    • Telephone Directory
    • Your Accommodations
    • Discharge Checklist/Home Care
    • Food Service Options
    • Your Hospital Team
    • Your Medical Bill
    • Your Protection
    • Your Safety & Security
    • Your Needs
    • Advance Directives
    • Physical Activity
    • Medical Records
    • Pricing for Healthcare Services
    • Affordable Care Act
    • Your Health Insurance Coverage
    • Window Box Gift Shop Hours
    • DAISY Award Nomination
    • Hospital Visiting Hours
    • Surprise Billing Disclosure
    • Visitors Guide
  • Find a Doctor
  • Careers WGH
    • Medical Staff Recruitment
    • Benefits
    • Careers