Health Information | Memorial Hospital | Fremont Ohio

You have the right to access your health records. You may view or receive copies of your records.,  Ask for an “authorization for the release of information” form, or click the link below to download it. Complete the form and return it to Memorial Hospital as directed. It can take up to 60 days to receive your medical records, so ask when you can expect to receive the information you requested.

You also have the right to request that changes be made to your health record. If you believe that information in your record is incomplete or incorrect, you can request an amendment. Amendments can be requested by either contacting the person who made the entry (such as your doctor) or by contacting your healthcare organization’s health information management professional. If your request for an amendment is denied you may still request that your request for a change be kept with the record and given to anyone who requests a copy of your health information. Also, you may choose to include the amended information in your medical record.

Authorization for Disclosure of Patient Identifiable Health Information (88 KB)

 Download information about Living Wills and Advance Directives:

Advance Directives Packet (1124 KB)

Visit the MCA Web site for more information regarding Living Wills and Advance Directives...

Notice of HIPAA Breach: Memorial Family Care - Old Fort
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