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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 (815) 725-7133 , extension 3100 or fax a request to
(815) 773-7042. The fee for medical records is a routine rate in accordance with Illinois State Comptroller's Office.
http://www.ioc.state.il.us/office/fees.cfm
2. En Espanol - "Autorizacion Para Usar Y Divulgar Informacion Medica"
3. Medical Records will be mailed out within approximately 5-7 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 (847) 695-3200, ext. 5326 or Fax (847) 717-6638.
Vital Records
If you are in need of vital records, such as birth and death certificates, please contact the Will County Clerk's Office at (815) 740-4615 or visit their website for more information.
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