Update Your Records By Mail

To update your records by U.S. Mail, please just print the Update Your Records Form (PDF version - link below), fill it out completely and mail it to one of the following locations:

• Northeast Ohio
  2060 East 9th Street
  Cleveland, Ohio 44115-1355
  Mail Zone: 01-6A-7509
  

  Northwest Ohio
  3737 Sylvania Avenue
  Toledo, Ohio 43623-4482
  

  Columbus Region
  9961 Brewster Lane
  Powell, Ohio 43065
  

  Dayton Region
  6450 Poe Avenue, Suite 111
  Dayton, Ohio 45414-2647
  

  Cincinnati Region
  Summit Woods Corporate Center II
  300 E. Business Way, Suite 370
  Cincinnati, Ohio 45241
  

Provider Information Forms can also be obtained by contacting your Professional Contracting Representative.

Update Your Records Form, PDF version

To view the Portable Document Format files (PDFs) on this site, download a free Acrobat Reader.

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