Medical Records

Medical and Billing Record Release Forms

Use these forms when requesting transfer of your medical and billing records to or from another provider or to obtain a copy of your records:

• TriHealth (any entity) Authorization for Disclosure of Protected Health Information (PDF)
• Spanish Version (PDF)

Requests should be directed to the facility you were treated at.

Bethesda Hospitals

Email: TrihealthhospitalMedicalRecords@TriHealth.com
Phone: (513) 865-1101
Fax: (513) 852-3900

Good Samaritan Hospitals

Email: TrihealthhospitalMedicalRecords@TriHealth.com
Phone: (513) 862-2435, option 1
Fax: (513) 852-3900

McCollough Hyde Memorial Hospital

Email: TrihealthhospitalMedicalRecords@TriHealth.com
Phone: (513) 524-5612
Fax: (513) 852-3900

TriHealth Physician Partners

Click here for a full list of TriHealth Locations

Other Medical Record Inquiries

If you have general medical record questions that cannot be answered by your physician practice or care team, our online contact form can be used for other medical record inquiries. Select Medical Records from the Subject options on the form. 

For other forms, please go to Patient Forms.