Provena Health is now part of Presence Health
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Authorization Forms

In order to protect your privacy, we require written authorization to release your medical records to another person or organization. Below is the Authorization for Release of Patient Health Information, which you can print, fill out, and return to the Health Information Management department as requested.

There may be fees assessed for generating copies of medical records.  Costs are generally determined on a per-page basis. 

Most requests are routinely completed in 10 business days.

Please note, you will need the free Adobe Acrobat Reader to open and print these documents.

Download the Authorization for Release of Patient Health Information

Fax Numbers – Health Information Management

Presence Covenant Medical Center – Urbana 217.337.8416
Presence Mercy Medical Center – Aurora 630.801.3125
Presence Saint Joseph Hospital – Elgin 847.717.6639
Presence Saint Joseph Medical Center – Joliet 815.741.7379
Presence St. Mary’s Hospital – Kankakee  815.937.5738

Presence United Samaritans Medical Center – Danville

217.431.4014

 

 

Locations

Presence Covenant Medical Center - Urbana
Presence Mercy Medical Center - Aurora
Presence Saint Joseph Hospital - Elgin
Presence Saint Joseph Medical Center - Joliet
Presence St. Mary's Hospital - Kankakee
Presence United Samaritans Medical Center - Danville
Presence Life Connections
Presence Medical Group (Physician Practices)

Medical Services

All Medical Services
Behavioral Health
Cancer/Oncology
Cardiac/Heart & Vascular
Diabetes, Endocrinology & Nutrition
Emergency & Critical Care
Imaging & Radiology
Neurology & Stroke
Occupational Health
Orthopedics
Presence Life Connections
Pulmonary, Sinus, Sleep
Rehabilitation / Therapy
Surgical Services
Women & Children

Patients & Visitors

Authorization Forms
Baby Photos
Billing Inquiries
Cafeteria / Gift Shop
Frequently Asked Questions
Guest Wireless Internet
It’s Flu Season
Health Plans / Medicial Insurance
Make an Appointment
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Medical and Vital Records
Patient Privacy Policy
Patient/Resident E-mail
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Visiting Hours

About Us

History/Overview
Mission Vision and Values
Respect Life
Powerful People
Commitment to Our Communities
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For Board Members