Request Medical Records
For information about your care at SIU Medicine
To request your medical records, you may complete an electronic request, fax, mail or email your request:
If you would like to electronically request copies, for yourself or a third party, of your medical records from SIU Medicine, please use this link. You will need a valid photo ID and mobile phone to complete the electronic request.
For all other requests, print and fill out the Authorization for Release of Confidential Medical Information form. You may fax the form to 217-545-7880. Email forms can be sent to firstname.lastname@example.org or mail your completed form to:
Central Medical Records
201 E. Madison St. Box 19641
Springfield, IL 62794.
- You may be charged a fee to acquire a copy of your medical records.
- Beginning June 1, 2021, SIU Medicine does not allow walk-in services for medical record requests.
- Please be aware that sending personal health information via an unencrypted email poses a risk of your information being accessed by an unintended third party. Sending information after this notification signifies receipt of warning and acceptance of said risk.