Request Medical Records

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We are happy to fill your request for your child's medical records. For Dayton Children's to release confidential medical record information please print, complete sign and date the authorization form. Please allow seven to 10 business days for your request to be completed.  Holidays, Saturdays and Sundays are not recognized business days. Requests received after 3:00 pm will be recorded as received the next business day.

Please note: For your protection, we cannot accept e-mail requests since a handwritten signature is required for us to release records.


Monday through Friday, 8:00 am to 4:30 pm*
Excluding holidays 
* Payment for copies must be made before 4:00 pm

Records for continuity of medical care

There is no fee for copying and sending medical records to another physician or health care provider. If you are requesting medical records for a medical appointment, please tell us the date of the appointment on your request. If the appointment is scheduled in the next two weeks, you will either need to call us to arrange to pick up the records or provide a fax number of the physician who will be treating your child.

Records for personal use

If you are requesting medical records for your own personal use, there is small fee. Prices include $0.50 per page for pages 1-50 and $0.20 per page for pages 51 and higher.  We charge $1.00 per page for copies of medical records made from microfilm/microfiche.  Pre-payment is required if invoice total exceeds $5.00. We may also charge for postage.

Charges for other requesters are set annually by the Ohio Department of Health. Ohio’s rates for copies of medical records are available on the Ohio Department of Health website.

To minimize costs, we suggest requesting a copy of specific dates of service rather than the entire medical record. If you are requesting records from an inpatient hospitalization, an "abstract" of the record gives you the essential elements of the record without having all the daily assessments. A typical "abstract" of an inpatient record would include; a discharge summary, operative notes and diagnostic testing.

*Patients 18 years old and older must sign the authorization form.

Payment for medical record copies

Available forms of payment include cash, check and credit card. We accept Visa, Mastercard, Discover and American Express. Credit card payments can be made by calling (937) 641-3395. Please make checks payable to Dayton Children's. 

Mail your payment with the invoice pay stub to:
Dayton Children's
One Children's Plaza
Dayton, OH 45404
Attn: Health information management

You may also pay in person in the health information management department between 8:00 am and 4:00 pm, Monday through Friday.

Immunization records

If you or your child received primary care services from the Children's Health Clinic (CHC), please call (937) 641-3500 to inquire about immunization records. 

The health information management department only has immunization records on file for patients treated in the primary ambulatory clinic prior to 1990.

Medical imaging/radiology department images

The health information management department maintains written reports of all diagnostic testing performed in the medical imaging department. 

To request x-ray films and other radiology images on a CD, call the medical imaging department at (937) 641-3888.

Patient billing statements

If you need copies of patient bills in addition to your medical records, please include your request for copies of specific patient bills on the medical records rauthorization form.  Please send your request to the health information mangaement department for initial processing. Your request for patient billing information will then be forwarded to the patient accounts department.

If you just need copies of patient bills and do not need any medical records,  please contact the patient accounts department at (937) 641-3555.

Mail or fax the form

The Children's Medical Center of Dayton
c/o Health information management dept.
One Children's Plaza
Dayton, OH 45404-1815

Fax: 937-641-5404
Phone: 937-641-3395

Contact us 

Call the health information management department, Monday through Friday, 8:00 am to 5:00 pm at (937) 641-3395. 


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The Children's Medical Center of Dayton Dayton Children's
The Right Care for the Right Reasons

One Children's Plaza - Dayton, Ohio - 45404-1815