contact information for fairfield memorial hospital
 
 

Medical Records

 
In order to obtain your medical records, you must fill out a "Release of Information Form" in entirety before your request can be processed. Feel free to mail your form in advance or simply bring the below form to the Health Information Department.
 
Copies of Films/CD of Diagnostic Images must be requested through the Health Information/Medical Records department.
Please allow twenty-four hours for processing to be complete.
 
Medical Records can be picked up in the Health Information Department located on the first floor of the hospital during the hours of Monday-Friday, 8 a.m. - 4:30 p.m.
  • To download a Release of Information Form to obtain your Medical Records, click here
  • Power of Attorney/Living Will Information is provided by the Social Services staff. You can also find important resources on the Ilinois Department of Healthcare & Family Services page. For more information, click here
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

Contact

 
Health Information Department
303 NW 11th Street
Fairfield, IL 62837
P: 618-847-8247
F: 618-847-8379
 
 
 
 
© 2011 Fairfield Memorial Hospital - Excellence in Community Healthcare
  Fairfield Memorial Hospital   |   303 N. W. 11th St.   |   Fairfield, IL 62837