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Patient Forms

The Pre-Surgery Packet is under “Other Patient Forms” near the bottom.

Other Patient Forms

Designation of Personal Representative Form
Authorization to Treat a Minor Form
One Medical Passport Pre-Surgical Assessment

Medical Records Requests

All requests for medical records are processed by Sharecare Health Data Services. Please print and complete this authorization form to Release Protected Health Information. The form must be completed in order for your request to be processed. Please fax the completed form to (513) 354-3705.

All medical records requests require a minimum of five (5) business days to process. You may check the status of your request by visiting Sharecare’s website. For additional information, please contact Sharecare Health Data Services at (513) 354-3736.

High School Sports Physical Forms

Ohio – Grades 7-12 Only
Indiana – Grades 6-12 Only
Kentucky – Grades 9-12 Only