Medical records

How patients can request medical records

Your medical records, also called protected health information (PHI), are available to you in the format you prefer. Your medical records can be sent to anyone including health care providers, employers or organizations. You can also request copies of your medical records for your own personal use.

There are three ways to request your medical records:

  1. Use the LiveWell app or website.
  2. Complete and submit one of these two forms: Patient Health Information Access Request Form PDF] or Authorization for Disclosure of Protected Health Information [PDF].
  3. Write us a letter requesting the release of your health information. The letter should include:
    • Patient first name, last name and date of birth
    • The specific health information you’d like released (e.g., specific date of service, specific condition, specific physician, date range)
    • The medical record format you prefer (paper or electronic)
    • The person designated to receive the records
    • Where to send your records
    • The signature of the person whose medical records will be released (or their legal representative)

Where to send your medical records request

You can submit your medical records request via email or mail to the hospital from which you’re seeking the records. If you send via mail, please address the envelope to the attention of the Health Information Management Department at the hospital. You also can stop in and drop off your request in person.

There is no cost if your medical records are being sent directly to a doctor or other health care provider. For other types of requests, there may be a reasonable fee. If you have questions about cost, please call the hospital at the number below.

Advocate Christ Medical Center
Advocate Children’s Hospital – Oak Lawn Campus
Phone: 708-684-5030
Fax: 708-520-1039
Email: cmc-srco-roi-him@aah.org
Address:
4440 W. 95th St.
Oak Lawn, IL 60453

Advocate Condell Medical Center
Phone: 847-990-5250
Fax: 847-362-6895 or 847-990-2612
Email: cond-himroi@aah.org
Address:
801 S. Milwaukee Ave.
Libertyville, IL 60048

Advocate Good Samaritan Hospital
Phone: 630-275-1429
Fax: 630-275-5890
Email: gsam-him-roi@aah.org
Address:
3815 Highland Ave.
Downers Grove, IL 60515

Advocate Good Shepherd Hospital
Phone: 847-842-5500
Fax: 847-842-4376
Email: gshp-roi@aah.org
Address:
450 W. Highway 22
Barrington, IL 60010

Advocate Illinois Masonic Medical Center
Phone: 773-296-5175
Fax: 773-296-3812
Email: immc-him-roi@aah.org
Address:
836 W. Wellington Ave., Room 1506
Chicago, IL 60657

Advocate Lutheran General Hospital
Advocate Children’s Hospital – Park Ridge Campus
Phone: 847-723-6150
Fax: 847-723-2193
Email: srco-lgh-roi@aah.org
Address:
1775 Dempster St., 3 South
Park Ridge, IL 60068

Advocate Sherman Hospital
Phone: 224-783-8713
Fax: 224-783-8992
Email: sher-roi@aah.org
Address:
1425 N. Randall Rd.
Elgin, IL 60123

Advocate South Suburban Hospital
Phone: 708-213-3335
Fax: 708-213-0128
Email: ssub-him-roi@aah.org
Address:
17800 S. Kedzie Ave.
Hazel Crest, IL 60429

Advocate Trinity Hospital
Phone: 773-967-5097
Fax: 773-967-4212
Email: trin-him-roi@aah.org
Address:
2320 E. 93rd St.
Chicago, IL 60617

Advocate Medical Group
Phone: 224-225-0888
Fax: 224-225-0850
Email: AMG-ROI@aah.org
Address:
2025 Windsor Dr
Oak Brook, IL 60523

How third parties can request medical records

If you’re requesting medical records for one patient, please send your request and, if needed, the authorization for disclosure of protected health information [PDF]. You may email or fax the form to the applicable hospital or group shown above.

If you’re requesting electronic data for multiple patients as a health care provider, health plan, or HIPAA business associate of a provider or health plan in need of electronic data to perform a payment or health care-related activity (e.g. HEDIS, audits, studies) as defined by HIPAA , please submit a completed Third Party Electronic Data Request [PDF] to the applicable hospital or group.