Advance Directives

WV E-Registry is a quick convenient way to assure that your advance directives are readily accessible to those who need them in order to guide their treatment of you, especially in crisis situations. Your advance directives can be faxed or sent to the number/address below and will be on file. Health care providers who have registered with the site can then access the site if someone is admitted but does not have their advance directives with them in order to treat the patient according to their wishes expressed in their advance directives. Fairmont Regional Medical Center is a registered user of the E-Registry. If you need more information about the service, visit www.wvendoflife.org.

WV E-Registry
Fax number: 1-304-293-7442 or copies of advance directives can be mailed to the registry at
WV Center for End of Life Care
P.O. Box 9022 Morgantown, WV 26506

You have the right to make decisions about your healthcare and the treatment you receive – regardless of your age or future condition. By planning ahead, your wishes for treatment can be known and honored.

An advance directive can help you do that. An advance directive is a legal document that allows you to convey your decisions regarding end-of-life care ahead of time.

What is an Advance Directive?
Two types of advance directives are legally recognized in West Virginia:

If you want to have both forms in one document, you can use a combined living will/medical power of attorney form.
Download Combined Document

  1. Living Will: This document instructs your physician on the type of care you want if you become terminally ill or permanently unconscious. You can use this form to avoid life-prolonging interventions, such as cardiopulmonary resuscitation (CPR), breathing machines and feeding tubes. If the only care you want at the end of your life is to be kept pain-free and comfortable, you may include that in this document.
    Download     PDF     DOC
  2. Medical Power of Attorney: This document allows you to designate a person to make healthcare decisions for you if you are unable to make them for yourself.
    Download     PDF     DOC

Personal Information

To assist Fairmont Regional Medical Center and other healthcare providers deliver the best care possible, print and fill out this form with all of your pertinent medical information and keep it with you at all times. Please be sure to share this information during your regularly scheduled physician office visits, and make sure someone else knows where it is kept in case of an emergency.

Health Information Management (Medical Records)

The Health Information Management Department at Fairmont Regional Medical Center is responsible for the safe keeping of your medical records. We will make every attempt to honor your request for a copy of your record in a timely manner in accordance with State and Federal laws.

The Health Information Management Department is open Monday-Friday from 8:00 a.m. - 4:30 p.m.

Release of Information    PDF    DOC

Fairmont Regional Medical Center
Health Information Management
1325 Locust Avenue
Fairmont, WV 26554
Phone: 304-367-7500
Fax: 304-367-7577

Request for Birth Certificates
Contact the West Virginia Health Statistics Center at (304) 558-2931.