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Download, complete, sign and date the Authorization to Release Protected Health Information to Another Facility (en español) and return via email, fax or mail. Please note that unsigned or undated requests will not be processed.
There are situations where there are charges for medical records. The State of Ohio, in House Bill 331, has established a fee schedule. See the fee schedule.
You may request copies of your own medical records or those of a minor child, or someone for whom you are the legal guardian or hold a Power of Attorney for healthcare. A copy of the guardianship or Power of Attorney for healthcare must be provided.
Spouses, children or the executor of the estate may request medical records for deceased patients. A copy of the death certificate or executor of the estate must be provided.
It generally takes up to ten business days to fulfill your request due to the large number of requests we receive.
No. We cannot fax medical records due to confidentiality issues.
Call the Financial Customer Services Department at 216-957-3250.
Please ask your attorney to submit a written request with a patient signed authorization to:
The attorney should include payment for the minimum $15.00 charge for the bill copy. The balance, if any, will be billed to the attorney.
Yes. There is a spot on the form for you to indicate if you would like radiology images sent to you.
Information on obtaining a birth certificate is available here.