Requesting Copies of Medical Records
To request a copy of your medical record from Neighborhood Family Practice, download, complete, sign, and date the Authorization for Release of Information. Mail, fax, or submit in person at Neighborhood Family Practice 3569 Ridge Road, Cleveland Ohio 44102 to the attention of the Medical Record Department. Please indicate on the authorization form if you prefer that the copy of the medical record be sent to the address specified on the authorization form, or if you prefer to pick up your copy from our office during business hours.
Please be sure to fill out the authorization form accurately and completely. Inaccurate information on the authorization form may cause delays in providing you with the information you requested. Please allow 30 days to process your request upon receipt.
Your medical record is also available through MyChart for FREE. Visit MyChart to learn more, login or sign up. If you need MyChart support call 216-281-0872.
Flat fee rate of $6.50 per request
Patients will be charged this rate when they receive their results, either in person or over the phone.
Monday – Friday 8:00 am – 4:30 pm
Neighborhood Family Practice
Medical Record Department
3569 Ridge Road, Cleveland, Ohio 44102