RECORDS REQUEST UPDATE - PLEASE NOTE:
COVID-19 UPDATE: For the safety of all patients and staff as the result of Coronavirus, we are requesting that patients and guests utilize our online medical records request option instead of onsite, person-to-person services inside our hospital. If you do not have access to a computer, please call the Medical Records Department at (330) 971-7375
MEDICAL RECORD, PATIENT PORTAL AND RADIOLOGY FILM REQUEST
The following links and information below will allow you to request your medical record, authorize Follow My Health patient portal requests and request copies of your radiology images:
MEDICAL RECORD REQUESTS:
Please print, complete, sign and date the Release of Information Authorization form:
Release of Information Authorization Form - PDF
You may either fax, email or mail the signed ROI Authorization form to:
Fax: (330) 971-7087
Address: Medical Records Dept. Western Reserve Hospital 1900 23rd Street Cuyahoga Falls, OH 44223
Please be aware that a charge may apply to your request; we will inform you of this prior to fulfilling the request.
You will receive a phone call if we are unable to complete your request.
If you have any questions, please call us at (330) 971-7414.
FOLLOWMYHEALTH PATIENT PORTAL REQUESTS:
Please print, complete, sign and date the FollowMyHealth (FMH) Authorization form:
FMH Authorization Form - PDF
A copy of your Driver’s License/ State Photo I.D. is also required.
You may either fax, email or mail in your completed and signed FMH Authorization form to:
You will typically receive instructions on accessing FMH via email within two business days.
RADIOLOGY FILM REQUESTS:
To request copies of your radiology images, please call 330-971-7320.
As of April 18, 2016, the Western Reserve Hospital Medical Records Department only has access to records dating from June 24, 2009 to present. Any records relating to care provided by Cuyahoga Falls General Hospital prior to June 24, 2009 are now retained by the Summa Health (SH) Medical Records Department. You may contact them directly for these requests at (330) 375-3930. We apologize for any inconvenience. If you have any questions, please contact us directly via your preferred method of communication (options above). Thank you for your understanding.