General Medical Records Request Form

Visit our Patient Portal Page Here
Please note that if attempting to review your child(s) medical records without portal access yet, please call medical records first to receive additional instructions at (330) 263-8615.

Welcome to Wooster Community Hospital (WCH)! We look forward to serving you and helping you achieve optimal health and wellness. We invite you to submit your medical records into our patient portal. This will ensure that you and your physician maintain current documentation of your medical history, family medical history allergies, prescriptions, and much more.

Our aim is always to exceed patient expectations and make you feel welcome. If you have any questions about the services we offer, please call Wooster Community Hospital at (330) 263-8615.

Downloadable Form

Patient Request for Health Information

Authorization for Disclosure

You may obtain access to a copy of your medical records by completing the Authorization for Disclosure form below. The form may be dropped off in the Health Information Management (HIM) department, located on the first floor of WCH, or you can fax the form to (330) 262-5427. In addition to submitting the completed Authorization for Disclosure form, please bring one type of identification with you, such as a driver’s license or photo ID to obtain the requested documents.

Authorization for Disclosure Form

Advance Directive/Living Will

Why is it important to complete Advance Directives?

Serious illness or injury can strike at any time, at any age, so it is important for anyone over the age of eighteen to think about filling out these documents. A Living will and/or Health Care Power of Attorney will help to ensure your wishes for life sustaining treatment are followed regardless of your age.

What is the Living Will?

Should you ever become unable to verbally communicate your wishes the Living Will lets you identify in advance, and in writing, your instruction regarding care if you are terminally ill or permanently unconscious.
What is the Power of Attorney for Health Care?

A Health Care Power of Attorney is a document that
allows you to name a person who will act on your behalf to make healthcare choices for you if you are not able to make choices for yourself.

Why is it important to complete both documents?

The Health Care Power of Attorney document identifies the person you trust to make any health care decisions for you should you be unable to make them for yourself, and the Living Will document makes your end of life/life sustaining care wishes known. Although both documents are important, your wishes in the Living Will should always be honored regardless of your Power of Attorney’s instruction.
It is your choice to complete one or both, but often people do choose to complete these documents at the same time.

Advance Directives/Living Will Form

For more information or to make an appointment call
Wooster Community Hospital Health System
(330) 263-8727