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
2902 Farber Drive
Champaign, IL 61822

In Person:

Carle Health Information Management Department
Located in the Interstate Research Park, near the intersection of I-57 and Olympian Drive. Download a PDF map and driving directions.

By Fax:

Submit forms via fax at: (217) 326-1801.

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.