Provena Covenant Medical Center
is now part of Presence Health
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Medical Records Requests

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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County Plaza Building
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