Access Your Medical Record

How to request a copy of your medical records

To request your medical records from Southeastern Medical Center please visit Southeastern Medical Center Medical Records Request.

How to release a copy of your medical record to someone else

To release a copy of your medical record to someone other than yourself, please complete an authorization to release information form and submit it through online, email, fax or mail.

If you are requesting a copy of another person’s record, you will need to provide legal documentation verifying legal guardianship, power of attorney for healthcare, executorship or next-of-kin relationship of a decedent. Parents may request copies of their minor child’s record if they have legal custody, and if the child is not legally emancipated.

Fees

Per Ohio Revised Code and HIPAA, there may be a fee for copies of medical records.

Medical record forms

* Requests for records prior to 2016 can be submitted through MyChart and will be forwarded to the correct processing team. Retrieving these records may take longer to complete and will be mailed to the requester’s address.

** If you return your form by email, it will not be secured by encryption and could be accessed by others outside OhioHealth.