Patients and Visitors
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Mile Square Health Center (MSHC)
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Medical Records Requests
Request Online
NEW! Request medical records with our new online tool. Your records are delivered right to you - no need to go and pick them up. Choose from Electronic or Mail delivery. Appropriate fees may apply: Fee Schedule for copies of records.
Note: please have your photo ID ready.
Click here to access patient records request
- Complete Online Request
- You'll be guided through every step of the process
- Review, Sign, & Submit Request
- And you are done!
Request in Person
In order to receive copies of your medical records, please complete a valid Authorization to Release Health Information Form. You can either download the form from the link below or obtain it by contacting:
Health Information Management (HIM)
Phone: 312.996.3350
Hours: 8 am - 4 pm, Monday-Friday
Address: 1740 W. Taylor, Admitting Department Suite 1100, Chicago, Illinois 60612
Appropriate fees may apply: Fee Schedule for copies of records.
- Authorization for Release of Health Information Form (English) Download (pdf)
- Authorization for Release of Health Information Form (Spanish) Download (pdf)
Send Authorization for Release of Health Information Form:
- By fax: 312.413.2822
- By US Mail (Health Information Management, 833 South Wood Street, Suite B-52 (M/C 772), Chicago, Illinois 60612)
- By email to recordrequest@uic.edu
