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PATIENT SCHEDULING/REFERRAL FORM OhioHealth Heart & Vascular Physicians North Central Patient Information: Patient Name: Date: Address: City: State: Zip Code: Main Phone #: Alternate Phone #:.

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Contact support

Fax your completed form to (614) 533-1155. Healthcare providers can order records through a faxed request.

Call (614) 533.6999 weekdays from 8 a.m. to 4 p.m., or use OhioHealth MyChart to schedule online.

Let us point you in the right direction. Complete the contact form below or call us at (614) 466-3543.

COLUMBUS, Ohio – The Ohio State University Wexner Medical Center announced today it is joining the Ohio Health Information Partnership's health information exchange, CliniSync, allowing the Medical Center to electronically share patient health information with more than 100 hospitals and 6,000 physicians statewide.

To ask questions or get more information about a bill for services you've received, please contact our Customer Call Center at (614) 566.5594 or toll-free at (800) 837.2455 or send an email to customercenter@ohiohealth.com.

Download a patient access form or request one by fax. Fax your completed form to (614) 533-1155. Healthcare providers can order records through a faxed request. The request must contain the patient's demographics and necessary information, such as test results, notes and discharge summaries.

You may file a grievance by: a) Calling Marion General Hospital at (740) 383-8949. b) Contacting the Ohio Department of Health by way of its Healthcare Facility Complaint Hotline at (800) 342-0553 or by writing to them at 245 N. High Street, Columbus, Ohio 43215.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232