Home > Patients and Visitors > Medical Record/Portal Request Preparing for Surgery Accepted Insurance Medical Record/Portal Request Patient Rights Third Party Privacy Links Notice of Non-Discrimination Maps and Directions Your Charges and Your Bill Requesting an Estimate Chargemaster FAQ Financial Assistance Program Billing and Collections Policy Financial Assistance Policy Code of Conduct Patient Experience Pharmacy Cafeteria Patient and Family Advisory Council (PFAC) Privacy Notice MEDICAL RECORD, PATIENT PORTAL AND RADIOLOGY FILM REQUEST The following links and information will allow you to request your medical record, authorize Follow My Health patient portal requests and request copies of your radiology images: Medical Records click here Follow My Health Patient Portal click here Radiology Film click here MEDICAL RECORD REQUESTS: Please print, complete, sign and date the Release of Information Authorization form: Release of Information Authorization Form - PDF A copy of your Driver’s License/ State Photo I.D. is also required. You may either fax, email or bring in your completed and signed ROI Authorization form AND a copy of your Driver’s License/ State Photo I.D. to: Fax: (330) 971-7087 Email: wrhmedicalrecords@westernreservehospital.org Address:Medical Records Dept.Western Reserve Hospital1900 23rd StreetCuyahoga Falls, OH 44223 You will receive a phone call when your request is complete. a. Please be aware that a charge may apply to your request; we will inform you of this when we call you. b. If you are having someone else pick up your records for you, please either include that information on your signed authorization or have your representative bring in a signed/dated note from you authorizing them to retrieve your records. They must also bring their photo ID. You will receive a phone call if your authorization is unsigned or otherwise incomplete and/or 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 bring in your completed and signed FMH Authorization form AND a copy of your Driver’s License/ State Photo I.D. to: Fax: (330) 971-7087 Email: wrhmedicalrecords@westernreservehospital.org Address:Medical Records Dept.Western Reserve Hospital1900 23rd StreetCuyahoga Falls, OH 44223 You will typically receive instructions on accessing FMH via email within two business days. You will receive a phone call if your authorization is unsigned or otherwise incomplete and/or if we are unable to complete your request. If you have any questions, please call us at (330) 971-7414. 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.