Release of Information
Patients or Patient Representatives: You may use the USACS Authorization for Use and Disclosure of PHI form to request your medical record(s), but use of this form is not required for patients requesting their own records.
Important: Please include your name, date of birth, date(s) of service (if known), last 4 numbers of your social security number, address, phone number, and where you would like your information to be sent.
Email, Fax, or Mail your request to:
US Acute Care Solutions
Attn: Patient Services Dept.
4535 Dressler Road NW
Canton, Ohio 44718
If you have any questions, please contact the Patient Services Department at 1-855-687-0618
*Attorney (or other 3rd Party) Requests for Billing Records received via the above means will be uploaded to ChartSwap and worked accordingly.