There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, one copy is provided at no charge. Patients may obtain their medical records indicated below.

1. To authorize the release of your medical records to another physician or third party, follow these instructions:


1. Download and print the Authorization to Release and Disclose Patient Information form.
2. Following the instructions and completing the form in its entirety will help ensure timely processing.
3. Fax (937-741-8366) or mail the completed, signed Release form to:

It may take 5 to 7 business days for your records to be ready to be picked up.

Physicians' offices may call the office during business hours and we will do our best to fax records for our mutual patients ASAP. Requesting 1 business day prior to the patient's visit will ensure you have the records you need. 937-439-3600937-439-3600.

Other Parties requesting medical records, must submit proper authorization to obtain medical records. You will receive a statement of our fees, which must be paid in advance. Payment by credit card is encouraged to expedite your request.