Electronic Record Requests
The formal request for the release of your healthcare information/medical records is a safeguard to protect your health care information mandated by the Health Information Portability and Accountability Act (HIPAA). The release of information form from Titusville Area Hospital can be obtained by clicking the button below and downloading the pdf.
After filling out the release of information form, mail it to the address below or scan and upload it to the electronic patient request form.
Contact Information
Call: 814-827-1851 Ext. 2310
Fax: 814-827-3868
Mail: 406 West Oak Street, Titusville, PA 16354
Hours of Operation: Monday–Friday, 7:30 am–4:00 pm
Fax: 814-827-3868
Mail: 406 West Oak Street, Titusville, PA 16354
Hours of Operation: Monday–Friday, 7:30 am–4:00 pm