Medical Records/Health Information

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.

  • To download a Release of Information Form to obtain your Medical Records, click here
  • Diagnostic Images must be requested through the Health Information/Medical Records department. Please allow twenty-four hours for processing to be complete.
  • Power of Attorney/Living Will Information is provided by the Social Services staff. You can also find important resources on the Ilinois Department of Public Health. For more information, click here
  • To access Patient Portal: click here
  • To download the Authorized Relative Certification, click here

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.

Contact the Health Information Department

303 NW 11th Street
Fairfield, IL 62837
P: 618-847-8247
F: 618-847-8379