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To Obtain Copies of Your Medical Records:
1. Print and complete the "Authorization to Use and Disclose Health Information" form. If you are unable to print this form, you may obtain a form as well as information on fees and payment methods by calling 217-337-2338 or fax a request to 217-337-2416. The fee for medical records is a routine rate in accordance with Illinois Statues & Regulations.
2. En Espanol - "Autorizacion Para Usar Y Divulgar Informacion Medica"
3. Medical Records will be mailed out within approximately 7-10 days. If you would like to pick up the records in person, please bring a photo identification to the Health Information Management Department located on the main level of the hospital.
4. Office hours are Monday through Friday from 8:00 a.m. to 4:30 p.m.
To request an Amendment of Your Medical Records:
1. Print and complete the "Request for Amendment of Medical Record". If you are unable to print this form, you may obtain a form by calling 217-337-2338 or Fax 217-337-2416.
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