We are happy to provide copies of your medical records, radiology films, and pathology blocks and slides upon request. The patient or patient’s representative must complete, sign and date a medical records release authorization form before we can provide the requested information.
Download the medical records release authorization form here:
Patient Information Authorization
You can submit your authorization form in one of the following ways:
Mail: St. Bernard Hospital, Attention: Release of Information, 326 W. 64th St., Chicago, IL, 60621
Fax: (773) 962-4219 (please call to confirm we received it)
Once we receive your authorization, we will process your request in ten to fifteen business days.
Charges for copies:
Handling charge $25.55
Pages 1-25 $.75 – $.96 per page
Pages 26-50 $.50 – $.64 per page
Pages in excess of 50 $.25 – $.32 per page
These rates are reduced by 50 percent for records released on CD.
You can pick up your medical records between 8 a.m. and 4:30 p.m. Monday through Friday. Go to the information desk at St. Bernard, 326 W. 64th St., Chicago, IL, 60621, and you will be directed to the Release of Information department.
If you have questions about your records request, call Release of Information at (773) 962-4089.