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 to Disclose PHI Form (PDF)
- TriHealth (any entity) Authorization to Disclose Billing Records Form (PDF)
Other Medical Record Inquiries
If you have general medical record questions that cannot be answered by your physician practice or care team, the our online contact form can be used for other medical record inquiries. Select Medical Records from the Subject options on the form.