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Louis Stokes Cleveland VA Medical Center

Release of Information

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 the Wade Park Campus, first floor, room 136B.

How to Request Information

To request your medical records, please complete and sign the requested information for the appropriate form listed in the column to the right. Mail or fax it to:

Louis Stokes Cleveland VA Medical Center
Release of Information / Medical Records
10701 East Boulevard
Cleveland, OH 44106

fax: (216) 231-3295

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

Requests for records will take approximately 10-14 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, photocopying fees may be assessed.


Patient Information

Patient Information
Eligibility
Make, Change, or Cancel and Appointment
Advance Directives
Patient Education
Customer Service
Discharge
Billing and Insurance
Release of Information
Patient Rights and Responsibilities

Release of Information Forms

pdf document Request for and Authorization to Release Medical Records or Health Information (VA 10-5345)
pdf document Individuals' Request for a Copy of Their Own Health Information (VA 10-5345a)

Related Links

Notice of Privacy Practices