Medical Records

UH Samaritan Medical Center
1025 Center Street
Ashland,Ohio 44805

419-207-2552 or 1-800-257-9917, ext. 2552

Medical records are provided as a courtesy for continuity of clinical care. Medical records are maintained by our Health Information Management (HIM) Department, open Monday through Friday from 8 a.m. - 4 p.m.

All record requests, with the exception of x-ray films, will be fulfilled through HIM. This includes medical records from lab and cardiopulmonary as well as the Samaritan Professional Corporation offices. Patients needing access to x-ray films should call and request x-ray film 24 hours prior to reporting to the Radiology Department.

How to Request medical records from HIM

Copies of medical records can be requested in one of three ways:
By mail:
Mail a completed authorization form to:
UH Samaritan Medical Center
HIM Department
1025 Center Street
Ashland, OH 44805

In person:
To find HIM, access the elevator in the Lobby of the Emergency Department Waiting Room. Take the elevator to the Basement. Once there, turn right and then make a left. There, you will find a window with a friendly member of our team ready to assist you!

By fax:
A completed authorization form can be faxed to 419-281-0544

Print Medical Records Request Form

The State of Ohio provides a two-tiered fee schedule for the cost of providing copies, one for patients and another for others. One free copy of a patient's medical record is provided, on receipt of appropriate request, to:

  • The Bureau of Workers' Compensation, the Industrial Commission, or the Ohio Department of Job and Family Services;
  • Patient or patient's representative if the record is necessary to support a claim for Social Security disability benefits and the request is accompanied by documentation that the claim has been filed.

 

The fee schedule for a patient or patient's personal representative is as follows:

  • $3.07/page for the first 10 pages
  • 0.64/page for pages 11-50
  • 0.26/page for pages 51 and higher

For data recorded other than on paper (x-rays, MRI or CAT scan, recorded on paper or film):

  • $2.10 per page
  • Actual cost of postage

The fee schedule for all other requestors is as follows:

  • $18.91 records search fee
  • $1.24/page for the first 10 pages
  • 0.64/page for pages 11 - 50
  • 0.26/page for pages 51 and higher

For data recorded other than on paper (x-rays, MRI or CAT scan, recorded on paper or film):

  • $2.10 per page
  • Actual cost of postage