Patient Center

BEFORE AND AFTER SURGERY
YOUR HOSPITAL TEAM
PATIENT RIGHTS
PRIVACY NOTICES
REQUESTING MEDICAL RECORDS
ACCEPTED HEALTH PLANS
PATIENT ACCOUNTING OFFICE
MAPS AND DIRECTIONS
HOSPITAL PHONE NUMBERS
SUPPORT GROUPS
ADVANCE DIRECTIVES

Requesting Medical Records

To request your medical information and/or your medical records file, please print and complete a release form and return to Carle Foundation Hospital:

1. Patient Information Release Authorization Form (pdf)
2. Patient Mental Health Records Release Authorization form (pdf)

Completed release forms can be returned to Carle by:

Mail:
Carle Foundation Hospital
Health Information Management
611 W. Park Street
Urbana, IL 61801

or

In person:
Carle Health Information Management Department
Located on Coler Ave. on the first floor of the building directly north of the Hospital Emergency Room entrance.

Important instructions for completing the authorization to release forms.

Please call the Health Information Department at (217) 383-3381 if you have any questions about completing the forms or obtaining copies of your medical records.

Please make sure you read the form carefully and fill it out completely (both sides) including
- Your contact information, date of birth or clinic number
- Specify the purpose (records sent to another provider for continuing care are copied at no cost)
- Be sure to use check off boxes as needed
- Include the full mailing address if you are requesting information be forwarded
- Sign and date the form
Please Indicate whether you wish to pick up or have the records mailed
Mental Health records may require special authorizations, signatures or releases. Please call our Health Information Management department at (217) 383-3381 for more information.