Release of InformationA patient, or his/her legal representative, may obtain a copy of their medical records, or have copies of medical records sent to another individual or entity, such as an insurance company or attorney. US Acute Care Solutions requires a completed and signed Authorization for Use and Disclosure form before releasing any documents to anyone, including the patient.
How to request a copy of your medical records:
- Print and complete the Authorization for Use and Disclosure of PHI form.
- The release form must be completed, dated and signed.
- Fax or mail the completed form to:
- US Acute Care Solutions
- 4535 Dressler Road NW
- Canton, Ohio 44718
- Fax: 330-492-8489