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Medical Records

You are welcome to request copies of your medical records. You may request copies of your records by completing an authorization form.

Authorization forms

Can be obtained in the Medical Records Department, faxed to you upon request or downloaded. There may be a fee for photocopies of your medical records copied, except for those being sent to your doctor. For more information, call the Medical Records Department at 216-363-3346.


Download Authorization Form

Below is our policy regarding release of medical records for St. Vincent Charity Medical Center, St. Luke’s Medical Center and St. Michael’s Hospital.

Ciox Health is under contract with St. Vincent Charity Medical Center to release all authorized copies of medical records.

Federal and other laws protect the confidentiality of the records. Therefore, Ciox Health employees will not forward confidential records without the proper authorization.

Please note that on average, all copies of medical records may take up to 7-14 days. Depending on availability and access of records from the date we receive the request, it can take as much as 30 days. Please be advised that each request is charged a fee for reproduction in accordance with House Bill 331. This fee will cover the clerical and labor expenses involved in the reproduction of the medical record.  For records beyond a three-year history, it may take longer to process. The fee schedule is posted below.

We do offer patients and requestors the opportunity to review the original medical record if they desire.  In order for a supervised review to take please, the requesting party must call correspondence department at (216) 363-3346 to schedule the review. Prior to reviewing any original medical record, the requesting party is required to show all proper documentation and/or authorization, which will be verified before the review can take place.

All correspondence letters, authorization and information release should be directed to:

Mail to:

Attn: Ciox Health ROI
St. Vincent Charity
Medical Records Department
Cleveland, Ohio 44115

Fax to:



1-10 pages$2.98 per page
11-50 pages$0.62 per page
51+ pages$0.26 per page

Records for Attorney, Insurance Claims and Workers’ Comp Claims

Initial Fee is $18.34
1-10 pages$1.20 per page
11-50 pages$0.62 per page
51+ pages$0.26 per page

M/film, MRI, CAT Scans


The fees can also be found at

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