Medical Records

Home 9 Health Clinic 9 Medical Records

Medical Records Request

If you would like to request medical records, please fill out the form below and fax it to 773-883-0005. If you have any questions, or would like to speak to someone concerning medical records, you may contact the front desk at 773-883-9100.

Medical Release Form

Please note that, the medical records department does not provide radiology films and has up to 90 days to fulfill requests as per our policy. Please call 773-883-9100 for more information regarding record requests.