Skip to main content
Go to homepage

Medical Records

Featured Image
Featured Image

Following our visitor restriction policy, our HIM office is closed to the public. Please contact us at 330-543-8552 or to receive a paper records release form by mail, or download it at the link below. Follow instructions below for return of the form by mail, fax or email.

Our Health Information Management department processes, stores and retrieves patient medical records. Current patients may also access their health records through MyChart. To sign up for MyChart, request an enrollment form at your next appointment.

How to request medical records

To request a copy of your medical record or your child’s record for personal use, please choose an option below. Be sure to include:

  • patient’s full name
  • date of birth 
  • specific records requested
  • treatment dates  
  • your name, address, phone number and relationship to the patient

Print the blank form, complete by hand and sign.


Complete the fillable (pdf) form using the required information above and sign using an e-signature (must include a photocopy of a government issued ID for proof), or print and hand sign.

Send completed forms by:

  • fax: 330-543-5360
  • email:
  • postal mail: 

ATTN: Health Information Management
Akron Children’s Hospital
One Perkins Square
Akron, OH 44308

All requests must be signed and dated. 

Healthcare professionals may fax signed releases to: 330-543-3886

Copies for doctors and other care providers are free, otherwise customary charges will apply.

Call Health Information Management at 330-543-8552 for more information.

Sending records to Akron Children's Hospital?

Use one of the forms below.

What next?