Medical Records

For a copy of your medical records, you must come in person with a valid driver’s license or state ID and ask to speak to a Health Information staff person. Complete and sign a medical release form which gives us permission to release your health information to other designated facilities. Based on your request there may be a charge for a copy of your medical record.

Download: Authorization for Disclosure of Health Information Form

If a health facility is requesting the health records, requests can be faxed, along with a copy of the patient’s identification to 773-978-8367 or emailed to ROI@chicagofamilyhealth.org.