Request Medical Records
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.
To request a copy of your medical records:
- 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.
- Medical Record Authorization Release – English
- Medical Record Authorization Release – Spanish
- Medical Record Authorization Release – Polish
- 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:
John H. Stroger, Jr. Hospital*
1969 W. Ogden Ave., Room 1370
Chicago, IL 60612
Hours: 8AM to 3:30PM
Phone: (312) 864-6152
Fax: (312) 864-9890
Provident Hospital
500 E. 51st St., ROI Dept.
Chicago, IL 60615
Hours: 8AM to 3PM
Phone: (312) 572-1527
Fax: (312) 572-1524
Cermak Health Services
2800 S. California Ave., 1st Floor
Chicago, IL 60608
Hours: 9AM to 4PM
Phone: (773) 674-3915
Fax: (773) 674-3881
*All health center records can be obtained here.
Payments & Rates
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. Click here to see current copying fees adjustments.
To Obtain Vital Records
Copies of birth, death and other official records for Chicago and suburban Cook County residents can be obtained from the Cook County Clerk’s office at www.cookcountyclerk.com or (312) 603-5656.
To Obtain Images
To request images, please contact:
Radiological Images: (312) 864-7070
Mammography Images: (312) 864-3805
Other Departments
To contact other departments, please see the numbers below.
Patient Support Center/Scheduling Options: (312) 864-0200
Billing Records: (866) 223-2817
Patient Referral Support Center, Fax: (312) 864-7039
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