Request a Copy of Your Medical Records
We are happy to provide copies of your medical records upon request.
Print a Medical Record Request Form.
Complete an Online Medical Record Request Form.
To Obtain Copies of Your Medical Records
- The authorization to release your medical records, radiology films and/or pathology blocks and slides must be completed, signed and dated by the patient or the patient's personal representative before copies can be provided.
- Your request will take five business days to be processed. Please allow additional days for mailing.
- If records are to be sent to your physician, please provide the name, address, fan number, appointment date and time. We will forward copies of your medical records directly to your physician at no charge.
- If you wish to pick up your records, you will be charged a copy fee (see cost below.) This includes taking them to a doctor. There is no charge for films or pathology blocks and slides.
- Charges for Copies: As allowed by 735 ILCS 5/8-2006, charges for copies of your records are as follows:
| Pages 1-25 |
$.92 per page |
| Pages 26-50 |
$.61 per page |
| Pages in excess of 50 |
$.31 per page |
| Copies made from microfilm |
$1.53 per page |
| Mailing charge |
Cost of postage |
- If you are going to mail in your authorization, send it to the address at the top of the page or fax it to (708) 923-4688. If you fax your request, call to confirm that it was received.
If you have any questions regarding your request, please call (708) 923-4664.
Medical Record Pick-up Hours
Medical Record pick-up is located in the lobby of the hospital. Go to the information desk and they will direct you.
Monday-Friday
7:30 a.m. - 5:30 p.m.
The department is closed on weekends and holidays.
