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Dayton VA Medical Center, Ohio

 

Request Your Medical Records

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
  • completion of forms for benefits, insurance, and other reasons

The Release of Information Staff are expert in our patients' rights regarding 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 copy, 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 (136)
Attn. Release of Information
4100 W. Third Street
Dayton, OH 45428


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

Patients requesting a copy of their own medical records should go to the Release of Information (ROI) office and sign VA Form 10-5345a. For requests for records to be provided to other providers, agencies, etc. the Veteran/guardian signs VA Form 10-5345.

For more information, please call (937) 267-3911.

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.

Contact

Release of Information Office
Building 310, Ground Floor, Room 1E-174
937-267-3911