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)
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.