Van Wert County Hospital Main Building, First Floor
Monday - Friday
8:00 a.m. – 5:00 p.m.
Personal Record Requests
It is important that you, our patients, have quick and convenient access to your medical records. To expedite your request, the following process has been established.
1. Complete the form titled, Authorization for Release of Medical Records.
2. Fax your request to 419-238-4668.
3. Call 419-238-8684 to verify that the fax has been received and to obtain the date when your
records will be available. Please allow 48 hours to complete your request.
4. When your request is ready, you will need to bring a Photo ID to identify yourself.
5. Your results will be available for pick up from the Medical Records Department Monday-Friday
between the hours of 8:00am-5:00pm
There is a charge for Medical Records and we will accept cash, credit cards, and personal checks.
Below is the pricing information:
|Pages ||Price |
|1-10 Pages ||No Charge |
|11-50 Pages ||$0.50 per Page |
|50 Pages and above ||$0.25 per page |
|Face Sheets for DMV ||$1.00 per Face Sheet |
Personal Radiology/Imaging Films or CD Requests
Radiology requests follow the process listed above under Personal Record Requests.
Records for Physicians
If your physician is a physician on staff at Van Wert County Hospital, he/she may access your medical records without you facilitating this request by contacting the Medical Records Department at 419-238-8684. If the office has requested that you personally request you medical record, you will need to complete the Authorization for Release of Medical Records and follow the process outlined above. There will be no charge for sending records to your physician office. A form must be completed for each physician you need your records mailed or faxed to. Please note that your records will be mailed unless you specify an appointment date and time.
Requests should be sent from Insurance Companies, Attorney Offices, or DDS, and mailed directly to the Medical Records Department, Van Wert County Hospital, 1250 South Washington Street, Van Wert, Ohio 45891 or faxed to 419-238-4668. All charges for medical records will be billed to the requestor with a fee schedule not included. Requestors may contact the Medical Records Department at 419-238-8684 for pricing inquiry.