Home > Patient Information > Resources > Medical Record Release Form

Aultman North Canton Medical Group will not use or disclose your health information for any reason unless you have signed a form authorizing us to do so. You have the right to cancel your authorization in writing unless we have taken any action in reliance on the authorization.

Please complete the Authorization for Release of Health Information form and return to:

Mail:
Medical Records Department
Aultman North Canton Medical Group
6046 Whipple Ave. NW
North Canton, OH 44720

Fax:
330-305-5014

How do I get access to my medical records?

Aultman’s Medical Records Departments are responsible for keeping complete medical records for each patient. Your original medical record is property of Aultman, but you can access your health information by requesting copies.

At the end of your care episode, you may request copies of your finalized patient record. In order to receive copies of your medical record, or to send copies of your medical record to others, you will first need to complete the appropriate release of health information form:

For more information on this process, please click here.
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