Request Medical Records

To request your medical records, you may fax, mail or email your request:

Print and fill out the Authorization for Release of Confidential Medical Information form. Call 217-545-4331 or email for further assistance.

You may fax it to 217-545-7880

Email it to

or mail your completed form to:

SIU Medicine
Central Medical Records 
201 E. Madison St. Box 19641
Springfield, IL 62794.


  • You may be charged a fee to acquire a copy of your medical records.
  • Beginning June 1, 2021, SIU Medicine does not allow walk-in services for medical record requests.
  • Please be aware that sending personal health information via an unencrypted email poses a risk of your information being accessed by an unintended third party. Sending information after this notification signifies receipt of warning and acceptance of said risk.