Medical Record Request
Request medical records electronically
Electronic Authorization for the Release of Medical Information
Use the link above to complete and electronically submit a request for records that will be released via mail or secure email.
Request medical records via fax or mail
Authorization for the Release of Medical Information
Use the link above to access, print, and complete the authorization form.
- Complete all fields on the authorization form when requesting the release of your records.
- If you do not know your EMS Incident number, leave it blank.
- After the form is signed and dated, fax the information to the number indicated at the bottom of the form or mail it to the address indicated.
If you have any questions or need additional information, contact EMS Office of Medical Records.
Fax Number: 216.623.4599
Phone Number: 216.664.6077
Hours: 8 a.m. - 5 p.m., Monday - Friday.
Resources
HIPAA Compliance
HIPAA Compliance ensures that patients' privacy rights are protected and that EMS employees are following the federal HIPAA (Health Insurance Portability and Accountability Act of 1996) laws for patient information.
Complaints and Feedback
216.664.2047 or 216.664.2013 - EMSFeedback@city.cleveland.oh.us
The OICCEA is responsible for the investigation of internal and external complaints of misconduct. Once an investigation is completed, they submit their recommendations based on the facts to the Commissioner of the Division.