Medical Records

Medical Records

Mount Carmel has process and procedures to ensure timely release of medical records for care received at our hospitals and other medical facilities.

How can I obtain a copy of my medical record?

Mount Carmel has two forms available for medical record release.

Online Request Application for Patients

Click the button to submit a request through our secure online request application with request status tracking. Please have your driver’s license or photo ID ready. Copies of medical records may be provided via MRO on-line portal, US Postal mail, or secure email.

Patient Directed Access Request Form

You may download the “Request For Patient Directed Access To Protected Health Information (PHI)” form to request on-site access to your records, to obtain a copy of your records via US Postal mail or secure/unsecure email, or to direct Mount Carmel to send your records to a third party.

Authorization Form

The authorization form is required when a patient or his/her representative is authorizing disclosure to another person/entity. You may download the “Authorization for Use & Disclosure” Form.

Mount Carmel will accept an outside authorization form as long as it meets all legal requirements for a valid authorization.

Where do you send the medical record request for access or authorization form?

Patient Directed Access and Authorization forms may be submitted in-person, email, or mailed to Mount Carmel’s Health Information Management Department at:

Mount Carmel St. Ann’s 
Health Information Management 
495 Cooper Road, Suite 200 
Westerville, Ohio 43081

Email requests to:

To avoid delays, please make sure the form submitted is completed and signed and dated by the patient or patient’s representative.

If you have questions please contact Mount Carmel Health Information Management at 380-898-4075 for more information. Hours of operation are 8:00 a.m. – 4:15 p.m., Monday - Friday, and we are closed weekends and holidays.  Effective September 1, 2023, we will be closed for lunch from 11:55 a.m. to 1:00 p.m. Monday – Friday.

How soon can I expect the medical records request to be completed?

Your request for medical records will be processed within 30 calendar days from receiving the completed request unless we notify you that the request cannot be processed within that time frame, the reason for the delay, and the date by which we will complete action on the request.