Health Information Management | Obtain Medical Records

To get medical records, print the form you need and mail it to: 

Cincinnati Children’s Hospital Medical Center
Health Information Management
MLC 5015
3333 Burnet Ave.
Cincinnati, OH 45229

• Form for Authorization for Use and / or Disclosure of Protected Health Information (58k)
• Form for Authorization for Use and / or Disclosure of Protected Health Information to Schools (163k)

There may be times when you are not available to bring your child for medical care. You can fill out a “Permission to Authorize Consent for Treatment” form to allow another individual that you name to give legal consent for medical care and procedures. You must have this form notarized, and it expires one year from the date you sign.

Attention, Parents
If your child is 18 years of age or older, it is REQUIRED by law that he or she sign a “Authorization for Use and / or Disclosure of Protected Health Information” form allowing release of the medical record, including to release the record to you.

Requests for all information (progress notes, consent forms, registration sheets, etc.) can delay processing and become very costly. If you need help deciding what to request, a patient information coordinator will assist you. Call 513-636-8233.

If you are requesting information for continuing patient care, the caregiver receiving the information usually wants only an overview of the important information. (This usually meets the need for individual use as well.)

A patient / physician abstract contains:

• Discharge summary −   The care, treatment and services provided as well as progress toward established goals of an inpatient stay
• Emergency record − The care, treatment and services provided for a visit to the emergency room
• History and physical −  The present illness or care needs and notes about any important history
• Operative report(s) −  The surgeon’s findings, technical procedures used, specimens removed and post-operative diagnosis
• Consultation report −  The findings of a physician requested to examine a patient
• X-ray reports, labs or other tests  
• Clinic notes − Include the initial assessment and the most recent visit documentation

If you are an attorney and submit a subpoena for medical records and you are not the prosecuting attorney requesting records for reasons of child abuse or neglect, please also submit the Authorization for Use and/or Disclosure form signed by the patient/parent/legal guardian or a Court Order signed by a Judge or Magistrate. This will help ensure a timely response and valid record retrieval process.

Records sent to patient/parent/legal guardians or to providers for continuing patient care, are not charged. If records are being sent to another person or entity, there may be a charge. The person or entity identified to receive records will be sent a prepayment invoice once the total cost is determined.

All checks must be made payable to Cincinnati Children’s Hospital Medical Center. Payment may also be made using Visa or MasterCard by calling 513-636-4217.

Note that copies of medical records from other facilities may not be re-released by Cincinnati Children’s. They must be requested from the originating facility.