Solicitar Registros Médicos
Cook County Health patients, patient representatives, and/or attorneys can request copies of Medical Records by completing an electronic authorization form via the Verisma Request App (VRA) or submitting a Medical Record Authorization Release form either in-person or by mail/fax.
Para solicitar una copia de su historial médico:
- Submit your electronic authorization form via Verisma Request App (VRA) using the links below. Please complete all the required fields. Patient/Patient Representative will need to upload a copy of their government-issued photo ID for verification purposes. Record requests are handled by Cook County Health’s (CCH) medical records partner, Verisma (ScanSTAT). Requests will be processed within 3-5 business days.
- Patient VRA
- Patient Representative VRA
- Attorney VRA
- To check the status of an online request, please contact: [email protected]
If you prefer to complete a paper authorization, click on the link below to download and print form.
- Autorización de divulgación de registros médicos - Inglés
- Autorización de divulgación de registros médicos - Español
- Autorización de divulgación de registros médicos - Polaco
- Must include copy of government issued photo ID for verification purposes.
Your paper request form can be mailed/fax or submitted in person at the appropriate CCH location below:
Hospital John H. Stroger, Jr.*
1969 W. Ogden Ave., Room 1370
Chicago, Illinois 60612
Hours: 8AM to 3:30PM
Teléfono: (312) 864-6152
Fax: (312) 864-9890
Hospital Providente
500 E. 51st St., ROI Dept.
Chicago, Illinois 60615
Hours: 8AM to 3PM
Teléfono: (312) 572-1527
Fax: (312) 572-1524
Servicios de salud de Cermak
2800 S. California Ave., 1st Floor
Chicago, Illinois 60608
Hours: 9AM to 4PM
Teléfono: (773) 674-3915
Fax: (773) 674-3881
*Todos los registros del centro de salud se pueden obtener aquÃ.
Pagos y tarifas
Once medical records are ready, an invoice will be mailed to you.
Cook County Health (CCH) may charge a reasonable fee for copying medical records that shall not exceed what the Illinois State Law allows. There is a $6.50 flat fee for patients and/or patient representatives who request electronic medical records on a CD.
CCH refers to the Illinois State Comptroller’s Office when calculating copying fees for medical records. Haga clic aquà to see current copying fees adjustments.
Para obtener registros vitales
Se pueden obtener copias de registros oficiales de nacimiento, defunción y otros registros de Chicago y los residentes suburbanos del condado de Cook en la oficina del secretario del condado de Cook en www.cookcountyclerk.com o (312) 603-5656.
Para obtener imágenes
Para solicitar imágenes, por favor contactar a:
Imágenes radiológicas: (312) 864-7070
Imágenes de mamografÃa: (312) 864-3805
Otros Departamentos
Para contactar con otros departamentos, consulte los números a continuación.
Centro de apoyo al paciente/Opciones de programación: (312) 864-0200
Registros de facturación: (866) 223-2817
Centro de soporte para derivaciones de pacientes, fax: (312) 864-7039
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