Chillicothe VA Medical Center
Request Your Medical Records
Our Release of Information (ROI) staff is happy to assist you with requests for your medical records.
They can assist you with the following:
- Accessing and obtaining copies of your medical record
- Explaining the process for correcting your medical record
- Working with your physician to get insurance, disability and other forms completed
The ROI Staff is knowledgable in all laws covering release of information and protection of patient privacy. They are located in Building 31, Ground Floor, room G200.
How to Request Information
To request copies of your medical record for yourself, please complete VA Form 10-5345a.
To request copies for another person (doctor, lawyer, insurance complany, etc), please complete VA Form 10-5345.
Return completed forms to:
Release of Information(538/161F8)
VA Medical Center
17273 State Route 104
Chillicothe, OH 45601
Forms may also be faxed to 740-772-7082 (Attention: Release of Information)
Because forms must contain an original signature, e-mailed forms cannot be accepted.
All Veterans are entitled to one complete copy of their medical record at no cost. Copies of medical records are also sent to other doctors and health care providers at no cost.
There may be copy/processing costs for other medical record requests.