Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

• access to your medical records
• obtaining copies of your medical records
• requests to amend your medical records
• completion of forms for benefits, insurance, and other reasons

The Release of Information Staff is expert in our patients' rights and their medical records.

The Release of Information Office is located in Building 310, Ground floor, room 1E-174.

How to Request Information

To request a medical record, please use one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address —

Dayton VA Medical Center
Patient Business Service
Attn: 136
4100 W. Third Street
Dayton, OH 45428

Because forms must contain an original signature, e-mailed forms cannot be accepted.

Requests for records will take up to 20 working days to process.

Fees

There is no cost to send copies directly to another health care provider. If copies are for a patient's personal use, one copy is provided at no charge.