Medical and Vital Records
Looking for information on routine medical records? You might be able to find it in the list below. If not, please send us an e-mail with your question.
The local county clerk's office maintains official birth records, so you will need to contact the vital records department of the Cook County Clerk's office. You can visit one of their locations in person, or you can find them on the web by visiting the Cook County Clerk's Office.
In order to protect your privacy, we require written authorization to release your medical records to another person or organization. Below is the Authorization for Release of Patient Health Information, which you can print, fill out, and return to the Health Information Management department as requested.
There may be fees assessed for generating copies of medical records. Costs are generally determined on a per-page basis.
Most requests are routinely completed in 10 business days.
- Open the Records Disclosure Authorization Form
- Open the Records Disclosure Authorization Form in Polish
- Open the Records Disclosure Authorization Form in Spanish
|Fax Numbers - Medical Records Department|
|Presence Holy Family Medical Center â€“ Des Plaines||847.297.8008|
|Presence Resurrection Medical Center||773.792.7911|
|Presence Saint Francis Hospital||847.316.3343|
|Presence Saint Joseph Hospital||773.665.3683|
|Presence Saints Mary and Elizabeth Medical Center|
|Saint Elizabeth Hospital||312.633.5937|
|Saint Mary of Nazareth Hospital||312.770.3373|
Frequently Asked Questions for Release of Information
Who is authorized to sign for release of my health information?
The following people are authorized to sign for release of your health information:
- The patient or the patient's legally authorized representative(legal documents must be provided);
- The parent of a patient under the age of 18;
- If the patient is deceased, authorization may be from the agent under power of attorney for health care (a copy of a death certificate may be required); the executor of the estate; special administrator; or next of kin*.
* The next of kin, upon presentation of a notarized Small Estate Affidavit, available from the Medical Records Department.
How much does it cost to obtain a copy of my health information?
There is no charge for releasing copies of health information directly to other healthcare providers.
To reduce the cost, patients should consider requesting specific information rather than a complete record.
|Number of Copies||Medical Records|
|Pages 1 - 25||$0.96 per page|
|Pages 26 - 50||$0.64 per page|
|Pages 51 and more||$0.32 per page|
|Microfilm||$1.60 per image|