How do I request Medical Records and Release of Information?

The steps involved depend on what records you want provided and/or for whom you want your records provided to.

In most cases, you will need to download and submit the following documents, which are available in our Patient Information Center:

  • Acknowledgement of Medical Record Request Processing Fee / Reconocimiento del cargo por procesamiento de la solicitud de registros médicos
  • Request and Authorization to Release Health Information / Peticion Y Autorizacion Para Liberacion Y Uso De Informacion Medica

Signed and completed authorization forms may be submitted in person, by fax or by mail:

In Person
Drop off the form at one of Aunt Martha’s Health Centers

By Fax (with copy of ID)

By Mail
Aunt Martha’s Youth Service Center
ATTN: Medical Records
19990 Governors Hwy
Olympia Fields, IL 60461

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Posted in: FAQs

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