Health Information Management, also known as the Medical Record Department, is responsible to fulfill all medical record requests for medical information. It is our policy to charge a nominal fee for all copies, except those sent from TMH to another health care facility (doctor's office or hospital). In good faith, an emergent request from a doctor's office or hospital will be fulfilled without the patient's signature on a release of information form. However, requests for records from insurance companies, attorneys or other entities will require the patient's authorization to release information. These requestors will be responsible for copy charges.
To request medical records be released, a Release of Information form needs to be thoroughly completed, signed by the patient and returned to the Medical Record Department either in person, by mail or faxed to 217-824-1659. A return phone number must be included in order to verify the request. If a person elects to pick up records, identification (driver's license or photo ID) will be required. Department hours are Monday through Friday, 8 a.m. to 5 p.m. Most requests will be processed within two (2) working days.
TMH's Release of Information form is available to download. You will need Adobe Acrobat Reader installed in order to read the downloaded file. If you would like to request a hard copy of the form, please call 217-824-1657.
HIPAA Authorization to Use and Disclose Health Information (Medical Release Form)