索取医疗记录
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.
要索取您的医疗记录副本：
- 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.
Your paper request form can be mailed/fax or submitted in person at the appropriate CCH location below:
John H. Stroger, Jr. 医院*
1969 W. Ogden Ave., Room 1370
芝加哥，伊利诺伊州 60612
Hours: 8AM to 3:30PM
电话： (312) 864-6152
传真： (312) 864-9890
和睦医院
500 E. 51st St., ROI Dept.
芝加哥，伊利诺伊州 60615
Hours: 8AM to 3PM
电话： (312) 572-1527
传真： (312) 572-1524
瑟马克健康服务
2800 S. California Ave., 1st Floor
芝加哥，伊利诺伊州 60608
Hours: 9AM to 4PM
电话： (773) 674-3915
传真： (773) 674-3881
*所有健康中心记录均可在此处获得。
付款和费率
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. 点击这里 to see current copying fees adjustments.
获取重要记录
芝加哥和库克县郊区居民的出生、死亡和其他官方记录的副本可从库克县书记官办公室获得，地址为 www.cookcountyclerk.com 或者 (312) 603-5656.
获取图像
如需图片，请联系：
放射图像： (312) 864-7070
乳房 X 线摄影图像： (312) 864-3805
其他部门
要联系其他部门，请参阅下面的号码。
患者支持中心/安排选项： (312) 864-0200
帐单记录： (866) 223-2817
患者转诊支持中心，传真： (312) 864-7039
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