Request Medical Records
For information about your care at SIU Medicine
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 firstname.lastname@example.org for further assistance.
You may fax it to 217-545-7880
Email it to email@example.com
or mail your completed form to:
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.