Coosa Valley Medical Center
The ChartFast platform allows you to manage requests for your medical records with the click of a button!
Submit your requests, check status, and make payment all online without the need to physically visit your providers’ offices. Records are released electronically back to you once payment is applied in our platform (for requests that require payment).
To Request a Copy of Your Medical Records
- Hospital Authorization to Disclose Health Information form must be completed, dated and signed by the patient (14 and Older).
- For patient requests, include a copy of valid photo ID (driver’s license, military ID, state/government ID, passport) for the patient and/or the individual who is the recipient of the records.
- If the patient is under the age of 14, physically or mentally incapacitated, or deceased, a legally designated representative may complete the necessary forms on behalf of the patient and submit the request. Legally Authorized Representative Form(s) (guardianship, executor of estate, Power of Attorney, etc.) must be included.
*There is no charge for having your medical records sent to another medical facility. If you want to obtain copies for personal reasons, you may be charged a minimal fee.
If you have any questions regarding release of health information, please call:
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Coosa Valley Medical Center Release of Information – 256-401-4494
To request Radiology CD Images and/or Film, contact Diagnostic Imaging – 256-401-4000
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If you encounter issues with creating an account, passwords, or if you get locked out of your account, etc., please call ChartFast at 855-764-9430 or email support@chartfast.com.
To make a request for new records:
Create your account at www.chartfast.com
Under new Requestor click “Register”
For Requestor Type, if you are a patient wanting records for yourself or to send to another physician choose “Patient” from the dropdown box
Fill out all information with a red asterisk *, be sure to check the boxes at the bottom left agreeing to privacy policy and terms and conditions then click the blue “Submit” button.
You will receive an email to confirm your account (be sure to check your Spam/junk folder if you do not see the email). If you do not receive the email please reach out to ChartFast at 678.829.4700 x2002.
Once confirmed you can go back to www.chartfast.com to request your medical records.
Click the green “Request Your Records” button to login to the ChartFast platform
Sign in with the user name and password that you created. Once you log in you will see the screen below.
Click the green “Make a New Request for Records” button
Click the drop down boxes and select the following;
State – Select Alabama
City – Select the City of your clinic
Custodian/Hospital Name – Coosa Valley Medical Center
Fill out all information with a red asterisk *. You will need to upload an authorization form or letter stating you would like your records.
Check the “HIPAA” button on Authorization type, then click the “Upload Authorization” button to upload your saved authorization/letter.
Once you have filled out all necessary information (all fields with a red asterisk * and uploaded your authorization letter) click the blue “Save and Send to Custodian” button at the bottom.
ChartFast will receive notification and begin processing your request.
Once completed, you will receive an email to login and retrieve and/or pay for the records (should there be a charge associated with the type of request you are making.)
If you have any question about this process, please reach out to us at 888-202-1671