Records

COPEDS charges an initial fee of $15.00 to offset record search and retrieval, plus the following fees* for copying of medical records:

  • Pages 1 through 10: $1.00 per page
  • Pages 11 through 50: $0.50 per page
  • Pages 51 and above: $0.20 per page
  • Postage

 

We will provide ONE free medical record copy only for:

  • Referral to another physician
  • Bureau of Worker’s Compensation claim
  • The Ohio Department of Job and Family Services
  • Support of a Social Security Disability claim

 

If you have not already signed a release form for your records, you can access the COPEDS Medical Records Release Form: click here.

 

To request a copy of your medical records:

Patient name *
Patient name
Patient Date of Birth
Patient Date of Birth
One free medical record copy will be provided for referral to another physician, Bureau of Worker's Comp claims, Ohio Department of Family Services, and/or support Social Security Disability claim. All other requests and requests for multiple copies will incur a charge (as per Ohio law 3701.74).
Requestor's name *
Requestor's name
Note: records will only be released to a guardian(s) listed in the medical record.
Address of physician/organization to send records to *
Address of physician/organization to send records to
Phone
Phone
Fax
Fax

If you have any questions regarding records fees, please email us at contacts@copeds.com