Your medical records

Requesting Your 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:

• Patient Information Release Authorization Form (PDF)
• Patient Mental Health Records Release Authorization Form (PDF)
• Addiction Recovery Release Authorization Form (PDF)

Completed release forms can be returned to Carle:

By Mail:

Carle Health Information Management
2902 Farber Drive

Champaign, IL 61822

In Person:

The Carle Health Information Management Department is located in the Interstate Research Park, near the intersection of Interstate 57 and Olympian Drive. Use Google Maps for driving directions from your location.

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.

The authorization will expire 90 days from the date signed unless otherwise specified. If you have any questions about completing forms or obtaining copies of medical records, call Health Information Management at (217) 383-3381.