How to Request Mercy Health Medical Records

Thank you for choosing a Mercy Health facility to receive your medical care. If you find that you need access to or a copy of your medical records, please print and complete the appropriate form found at the bottom of this page. Mail the completed form to the Mercy Health facility where you received care, and feel free to call the facility with any questions or if you need assistance completing the forms. If you are unsure of the address or phone number of the location, you can find it in our locations directory.

Records are kept off-site so please allow time for processing. A picture ID is required when picking up medical records. If you select to have your medical records mailed to your home or to another location, a copy of your photo ID must be included with the mailed or faxed request.

Did you know you can request your medical records though MyChart now – See MyChart for instructions.

Medical Record Release Forms

Find the region in which you received care in the list below, then download, complete and return the release form.

Cincinnati, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form

Send your request forms to:

Anderson Hospital
Health Information Management – ROI
7500 State Road
Cincinnati, Ohio 45255
Phone: (513) 732-8388
Email: ROI_Cincinnati_Springfield@mercy.com

Clermont Hospital
Health Information Management – ROI
3000 Hospital Road
Batavia, Ohio 45103
Phone: (513) 732-8388
Email: ROI_Cincinnati_Springfield@mercy.com

Fairfield Hospital
Health Information Management – ROI
3000 Mack Road
Fairfield, Ohio 45014
Phone: (513) 682-3629
Email: ROI_Cincinnati_Springfield@mercy.com

The Jewish Hospital - Mercy Health
Health Information Management – ROI
4777 E. Galbraith Road
Cincinnati, Ohio 45236
Phone: (513) 686-3629
Email: ROI_Cincinnati_Springfield@mercy.com

West Hospital
Health Information Management – ROI
3300 Mercy Health Blvd.
Cincinnati, Ohio 45211
Phone: (513) 215-0735
Email: ROI_Cincinnati_Springfield@mercy.com

Irvine, Kentucky

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form 

Send your request forms to:

Marcum and Wallace Memorial Hospital
Health Information Management – ROI
60 Mercy Court
Irvine, KY 40336
Phone: (606) 726-2157
Email: HIM_ROI_Kentucky@mercy.com  

Lima, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form 

Send your request forms to:

Mercy Health - St. Rita's Medical Center
Health Information Management – ROI
730 W. Market St.
Lima, OH 45801
Phone: (419) 226-9328
Email: HIM_ROI_Lima@mercy.com  

Lorain, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form

Send your request forms to:

Mercy Health — Lorain Hospital
Health Information Management – ROI
3700 Kolbe Rd
Lorain, OH 44053
Phone: (440) 960-3320
Email: OHMedCorresp@mercy.com

Mercy Health — Allen Hospital
Health Information Management – ROI
200 W Lorain St
Oberlin, OH 44074
Phone: (440) 775-4072
Email: OHMedCorresp@mercy.com

Paducah, Kentucky

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form 

Send your request forms to:

Lourdes Hospital
Health Information Management – ROI
1530 Lone Oak Road
Paducah, KY 42003
Phone: (270) 444-2997
Email: HIM_ROI_Kentucky@mercy.com  

Springfield, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form

Send your request forms to:

Springfield Regional Medical Center
Health Information Management – ROI
100 Medical Center Drive
Springfield, Ohio 45504
Phone: (937) 523-5393
Email: ROI_Cincinnati_Springfield@mercy.com

Mercy Health — Urbana Hospital
Health Information Management – ROI
904 Scioto Street
Urbana, Ohio 43078
Phone: (937) 484-6161
Email: ROI_Cincinnati_Springfield@mercy.com

Toledo, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form

Send your request forms to:

Mercy Health - St. Anne Hospital
Health Information Management – ROI
947 S. Wheeling
Oregon, OH 43616
Phone: (419) 696-5601
Email: HIM-ROI-Toledo@mercy.com

Mercy Health - St. Charles Hospital
Health Information Management – ROI
947 S. Wheeling
Oregon, OH 43616
Phone: (419) 696-5601
Email: HIM-ROI-Toledo@mercy.com

Mercy Health - St. Vincent Medical Center
Health Information Management – ROI
947 S. Wheeling
Oregon, OH 43616
Phone: (419) 696-5601
Email: HIM-ROI-Toledo@mercy.com

Mercy Health - Tiffin Hospital
Health Information Management – ROI
1100 Neal Zick Rd.
Willard, OH 44890
Phone: (419) 964-5050
Email: HIM-ROI-Toledo@mercy.com

Mercy Health - Willard Hospital
Health Information Management – ROI
1100 Neal Zick Rd.
Willard, OH 44890
Phone: (419) 964-5050
Email: HIM-ROI-Toledo@mercy.com

Mercy Health - Defiance Hospital
Health Information Management – ROI
947 S. Wheeling
Oregon, OH 43616
Phone: (419) 696-5601
Email: HIM-ROI-Toledo@mercy.com

Youngstown, Ohio

You can request a copy of your medical records, or the medical records of someone you have legal representation over in addition to authorizing records to be sent to another party by completing the form below:

English Form

Spanish Form

Send your request forms to:

Mercy Health - St. Elizabeth Youngstown Hospital
Health Information Management – ROI
1044 Belmont Ave.
Youngstown, OH 44501
Phone: (330) 480-2710
Email: Youngstown_ROI_request@mercy.com

Mercy Health - St. Elizabeth Boardman Hospital
Health Information Management – ROI
8401 Market St.
Youngstown, OH 44512
Phone: (330) 729-1926
Email: Youngstown_ROI_request@mercy.com

Mercy Health - St. Joseph Warren Hospital
Health Information Management – ROI
667 Eastland Ave.
Warren, OH 44484
Phone: (330) 841-4063
Email: Youngstown_ROI_request@mercy.com

When will I receive a copy of my medical record?

Please allow 30 business days for us to process your request. In some cases, the information you need may be stored at one of our offsite storage locations so additional time may be required to process your request. Please be sure to fill out the authorization form accurately. Inaccurate information on the form may cause delays in providing you with the information you requested.

Fees

If your request requires a fee, you will be notified of the fee before the record is sent.