Medical Records Request Policy
Providence Medical Group . . .
• Conforms to procedures for medical records requests established by Ohio statute.
• Permits medical records requests from a patient's representative as long as the request is signed by the patient.
• Requires that health care providers allow patients to examine their medical record without charge.
Providence Medical Group follows these guidelines for medical record copy charges:
• Health care providers or medical record companies will provide a copy of a patient's medical record for a minimal charge to certain persons or government agencies. Click here for our schedule of charges as of July 16, 2016.
• Adheres to Ohio statute requirements for the maximum fee that health care providers or medical record companies can charge for copies of a medical record.
• Will conform to annual adjustments to the maximum fee for medical record copies as mandated by the Ohio State Director of Health.
• As required by Ohio statute, will exempt copies of medical records provided to sickness and accident insurers and health insuring corporations from these provisions.
• Expect your medical record copies to arrive within 30 days.
Click here for Authorization to Transfer Medical Records form (pdf file)
Click here for Providence Physical Therapy Authorization to Transfer Medical Records form (pdf file)
Click here to read the relevant Ohio statute concerning medical records (pdf file).