Patients may request a copy of their medical records by completing and submitting an Authorization for Release of Personal Health Information form.
Please download and complete the authorization form to submit your medical record request by fax, email or mail.
Verification of identity may be required. Acceptable forms of identification include driver’s license, employment ID, state-issued ID, current school ID, military ID, VA. ID or a valid, current passport.
Medical Records Clerk:
Jan Darling
513-645-4585
FAX: 513-883-1546
jdarling@communityhealthalliance.com
Click here for the Standard Authorization Form
The Medical Records Department’s hours of operation are Monday – Friday, 8:30a.m. – 5 p.m. The department is closed on weekends and major holidays.
Please allow up to 30 day to process your request. If the requested information is located off-site or if the authorization form is not properly filled out, additional time may be required to process your request.
If this is an urgent request, please contact the Medical Records Department by phone.
