Caring for the community since 1932, Good Samaritan Hospital in Dayton, Ohio provides advanced services for heart and vascular care, orthopedics, cancer treatment, diagnostics, women's health, and much more.
About Good Samaritan Hospital
Good Samaritan Hospital (GSH) is passionate about providing the most recent medical advances and latest technology to residents of southwest Ohio—meeting the region's medical needs today and into the future.Learn about:
- Our Mission and History
- Ethics and Compliance
- The Tobacco Free Campus
- How We Serve the Community
- Our Awards and Recognition
- Our Commitment to Diversity
Samaritan Health Partners and Premier Health Partners are the members who own Good Samaritan Hospital. Good Samaritan Hospital is one of Catholic Health Initiatives hospitals.
Patient and Visitor Information
Whether you're a patient, family member, or friend visiting Good Samaritan Hospital (GSH), we'll work to make sure that quality services are provided to meet your individual needs.
Preparing for Your Visit
When planning to visit GSH, it's a good idea to research your upcoming experience—like available amenities, special services, medical records, and scheduling and registration.
Help Us Serve You Better
We Are Always Listening
Everyone at Good Samaritan Hospital (GSH) is committed to providing high-quality care, respect, and consideration for all our patients. We understand that your hospital stay may be a time of stress and uncertainty for you and your family and that you may have questions and concerns.
If at any time during your stay you have a question, comment, or concern about the services you have received, we encourage you to speak with your physician or the Nurse Manager on your unit. You can also contact the Customer Service Department weekdays from 9:00 a.m. to 5:00 p.m. at ext. 1000. Our Patient Representatives will help address any concerns you may have.
Patient and Visitor Comments and Complaints/Grievances
Patients have the right to file a grievance when a situation remains a continuing source of dissatisfaction. Please contact the Customer Service Department at (937) 734-1000, to do so. You may also file a grievance in writing by sending it to Customer Service, Good Samaritan Hospital, 2222 Philadelphia Drive, Dayton, Ohio 45406.
Taking Your Complaint to the Next Level
GSH is accredited by The Joint Commission and complies with the Conditions of Participation for Medicare and Medicaid. To express concerns not resolved through the hospital, visit The Joint Commission's website at www.JointCommission.org or call 1-800-994-6610. The Centers for Medicare and Medicaid may be reached at www.cms.hhs.gov or by calling 1-800-633-4227. You may also contact the Ohio Department of Health at www.odh.state.oh.us or by calling 1-800-342-0553
DISCLAIMER: Good Samaritan Hospital does not have any control over the content of third-party websites and neither endorses nor accepts any responsibility for the content, products, and services on or sold on these websites. The symbol indicates a third-party website.
Welcome to Good Samaritan Hospital's online Patient eServices.
At Good Samaritan Hospital we know that everyone has busy lives and schedules. Our Patient e-Billing will help you with that busy schedule. Paying your bills online is quick and easy.
Any time you have a question about your bill, you can speak to one of our customer service representatives by selecting Contact Us .
Below is an alphabetical listing of all Good Samaritan Hospital (GSH) services. Simply select the GSH service or department name for more details and contact information. Or choose the first letter of the service name from the alphabetical link at the top of the list to be linked to the services beginning with that letter.
Good Samaritan Hospital (GSH) maintains a confidential medical record for every patient. Your medical record contains complete information about all treatment and care you have received at GSH. A processing fee may be required.
While all GSH medical records and their contents are the property of the hospital, you have the right to view your medical record and can do so by requesting a copy or by making an appointment with the Medical Records/Health Information Management Services Department to come in and review your record in person.
All patient health care information at GSH is confidential. Medical records cannot be released to any person without the authorization of the patient or the patient's legally authorized representative (unless authorized by law).
To release your medical record to another individual or organization or review your record yourself, you must use the required Authorization for Release of Medical Information/Patient Access Form Form.If, after reviewing your records, you feel a change needs to be made, you may use the Amendment Request Form to request a change.
Frequently Asked Questions
Here are the most frequently asked questions about Good Samaritan Hospital (GSH) medical records. Selecting a question will take you directly to the answer, or scroll down the page to see answers to all the questions. If you cannot find the answer to your question here feel free to contact us.
- How do I request a copy of my medical record?
- When will I receive a copy of the medical record?
- How do I get a copy of my child's medical record?
- Can I get a copy of my living relative's medical record?
- I was born at GSH. Can I get a copy of my birth certificate from you?
- How do I get a copy of my deceased relative's medical record?
- I was adopted and am trying to obtain medical information about my birth parent, who had been a patient at GSH.
- Is there a cost to obtain my medical records for patient care?
How do I request a copy of my medical record?
You will need to complete and submit an Authorization for Release of Medical Information/Patient Access Form . This is your authorization to copy your medical record, or parts of your record, and forward it to another person or organization. Visit the Requesting a Copy page for more information.
When will I receive a copy of the medical record?
Copies are processed within 10 working days from the date the request is received. If you come to the Medical Records/Health Information Management Services Department to pick up your copy, please bring a photo ID.
How do I get a copy of my child's medical record?
You can request a copy if your child is age 17 or younger. Complete and submit an Authorization for Release of Medical Information/Patient Access Form . Individuals age 18 and older must authorize the release of their own medical record. Visit the Requesting a Copy page for more information.
Can I get a copy of my living relative's medical record?
If your relative is unable to sign the Authorization for Release of Medical Information/Patient Access Form , his or her power of attorney can request the copy. Legal documentation must be provided by the individual who is serving as power of attorney.
I was born at GSH. Can I get a copy of my birth certificate from you?
Birth certificates for anyone born at GSH are available from the Dayton Bureau of Vital Statistics at (937) 225-4418
Only the representative of the estate of a deceased patient may request a copy of the medical record. You must provide copies of the death certificate and the representative of estate legal documents.
I was adopted and am trying to obtain medical information about my birth parent who had been a patient at GSH.
Without written authorization from the birth parent, information about the birth parent cannot be released.
Is there a cost to obtain my medical records for patient care?
No. Processing fees will apply to all other requests.
Your Medical Decisions
Your medical decisions are important to Good Samaritan Hospital (GSH). GSH offers you advance care planning tools to ensure your treatment preferences are respected.
You are the person most qualified to make decisions about your medical care, including any decisions to choose or refuse medical treatment if you become terminally ill or permanently unconscious and unable to make your own health care decisions. If that happens, you can help ensure your preferences are respected by physicians, family, and friends by completing an advance directive(s). In Ohio, two types of advance directives are frequently utilized by individuals to ensure that they remain in control of their health care:
- Ohio Living Will
- Ohio Health Care Power of Attorney
Document and Record Your Treatment Preferences
“Advance directive” is a legal term that refers to a person's instructions for how his or her future medical care decisions should be made when he or she is not able to make those decisions for himself or herself. An advance directive is a written legal document.
For example, if a patient becomes terminally ill and is no longer able to express himself or herself, an advance directive can express the patient's wishes or designate a proxy to inform the health care team about the patient's wishes regarding the continued use or withdrawal of life-sustaining treatment.
Communicate Your Wishes for Life-Sustaining Treatment
Advance directives allow you to communicate your end-of-life care wishes not only to doctors, but also to family and friends. These documents can help family members feel more confident that they know what their loved one would or would not want when difficult medical care decisions regarding life-sustaining treatment have to be made.
Who Needs an Advance Directive?
Some people wait until they are seriously or terminally ill to prepare an advance directive. However, anyone may be the victim of unexpected illness, accident, or serious injury. It is best to complete advance directives when you feel well and have had the opportunity to discuss your wishes with your loved ones and doctors.
Types of Advance Directives
Ohio Living Will
An Ohio Living Will is a legal document that specifies the medical care or life-sustaining treatment you do or do not want to receive if you become terminally ill or permanently unconscious and are unable to speak for yourself.
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Ohio Health Care Power of Attorney
An Ohio Health Care Power of Attorney is a legal document in which you designate another person to make your health care decisions in the event you are unable to do so for yourself. A Health Care Power of Attorney takes effect when you are unconscious, incapacitated, or otherwise unable to make medical decisions, even temporarily.
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A packet entitled “Choices: Living Well at the End of Life,” which includes Ohio's Living Will and Health Care Power of Attorney forms and additional information about advance directives, may be downloaded for free on the Ohio Hospice and Palliative Care Organization website .
After Completing an Advance Directive
If you decide to complete an advance directive, we encourage you to give copies to your physician and loved ones. Keep the original copy in a safe place where you keep your other important papers. Furthermore, if you are to be admitted to GSH, please bring a copy(ies) of your advance directive(s) with you so it can be included in your medical record.
If you have questions or concerns about advance directives, our Customer Service staff is available to assist you. Call (937) 734-1000, for assistance. Or download a booklet from GSH that will provide you with additional information about advance directives and end-of-life issues.
Patient Scheduling and Registration
The Good Samaritan Hospital (GSH) Scheduling Department schedules exams for outpatients. The scheduling phone number is (937) 734-8274 , option 2. Hours of operation are 6:00 a.m. to 6:00 p.m., Monday through Friday.
A completed physician order is necessary for exams to be scheduled. The order must include the patient's name, exam to be performed, diagnosis/signs/symptoms, signature of the ordering physician, and date and time of the order. The order may be scheduled by phone through the Central Scheduling Department by either the patient or the physician's office. The order can then be faxed to Central Registration at (937) 734-7663 if the exam is at the main campus, or to Good Samaritan North Registration at (937) 734-5748 if the exam is at Good Samaritan North. The patient may also bring the order with him or her the day the test is scheduled.
Central Registration hours of business are 5:00 a.m. to 10:00 p.m. Monday through Friday, and 6:00 a.m. to 10:00 p.m. on Saturdays, Sundays, and holidays.
When you arrive at GSH, you will check in at the front desk in the main lobby. The Patient Access Specialist will key your name into Access, give you a coaster, and ask you to be seated in the waiting area. When it is your turn to register, the Patient Access Specialist will light up the coaster and greet you in the lobby by calling out the coaster number. You will then be escorted to the registration booth, where your demographic information will be updated, co-pay collected, forms signed, and insurance cards scanned. An escort will then guide you to your test/procedure or nursing unit for patients being admitted to the hospital.
Registration Documents to Bring to the Hospital
Outpatients or patients checking in are advised to bring the following documents with them to make the registration process faster and easier:
- Physician's order for test/admission if your physician provided one
- Insurance card
- ID/driver's license
Parking is available in the hospital garage located off Philadelphia Drive. A parking pass is given to each patient at the point of registration and is valid for one exit out of the garage on the day of your test.
Emergency Department Access
The GSH Emergency Department (ED) is open 24 hours a day, every day of the year. The ED is located just off Benson Drive at the back of the main hospital, between Sherwood Drive and Salem Avenue. There is a designated parking lot for patients just outside the ED. All patients must utilize the parking area and will be issued a token to exit the parking area at the end of their ED visit.
All patients should have current insurance card(s) and a valid identification card with them when they come to the ED. ED patients will check in at the front reception (Triage) window upon arrival. Patients will be signed in, assessed (triaged), and seen for care as prioritized by the clinical staff.
We maintain a hospital directory listing the name, room and extension, general condition, and, if you wish, your religious affiliation. Unless you choose to have it excluded from this directory, the information—excluding your religious affiliation—will be disclosed to anyone who requests it by asking for you by name. This information, including your religious affiliation, may also be provided to members of the clergy. You have the right during registration to have your information excluded from this directory and also to restrict what information is provided and/or to whom.
If you choose to be excluded from the hospital directory, you will receive no calls, mail, or flower delivery. The hospital will tell callers—including family members, friends, and clergy to whom you have not given your direct hospital phone line—“I'm sorry, this person is not in our hospital directory.”
For reasons of privacy and confidentiality, no information will be revealed to anyone about a patient who chooses not to be included in the facility directory.