Requesting Your Medical Records
Access Your Medical Records through MyChart
You can sign up to view your or your child's medical record from your computer or smartphone using MyChart. MyChart enables you to request medical records, view test results, schedule appointments, or refill prescriptions. However, there are some limitations to what can be viewed in MyChart.
Request Your Medical Records Electronically
To request your medical records electronically, use the region specific links below. In processing this request, you will be asked to validate your identity and give authorization for your record's release.
To help us serve you better, please set your location for information on how to access your medical records. The appropriate forms will load based on your location.
Request Medical Records via Mail, Fax, or Email
In Illinois, complete and return the Authorization for Release of Protected Patient Health Information form.
Questions?
Navigate to your SSM Health facility to find contact information for a medical records representative.
Mail to:
ATTN: HIM Department
1 Good Samaritan Way
Mt. Vernon, IL 62864
Fax to: 618-899-4764
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 618-899-2030 Select Option 1
Mail to:
ATTN: HIM Department
400 N. Pleasant Ave.
Centralia, IL 62801
Fax to: 618-436-8016
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 618-436-8700
Request Medical Records via Mail, Fax, or Email
In Mid-Missouri, complete and return the Authorization for Release of Protected Patient Health Information form.
Questions?
Navigate to your SSM Health facility to find contact information for a medical records representative.
Mail to:
SSM Health St. Mary's Hospital - Jefferson City
2505 Mission Drive
Attn: Release of Information/HIM
Jefferson City MO 65109
Fax to: 573-681-3632, option 1
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 573-681-3290, option 1
Monday-Friday, 8 am - 5 pm CST
Request Medical Records via Mail, Fax, or Email
If you are requesting medical records from an Oklahoma hospital, use this Authorization for Release of Protected Patient Health Information form.
Questions?
Navigate to your SSM Health facility to find contact information for a medical records representative.
Mail to:
SSM Health St. Anthony Hospital - Oklahoma City
ATTN: Medical Records
1000 N. Lee Ave.
Oklahoma City, OK 73102
Fax to: 405-231-8897
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 405-272-7400
Mail to:
SSM Health St. Anthony Hospital - Oklahoma City
ATTN: Medical Records
1000 N. Lee Ave.
Oklahoma City, OK 73102
Fax to: 405-231-8897
Email it:
ssmhealthintake@mrocorp.com
Mail to:
SSM Health St. Anthony Hospital - Oklahoma City
ATTN: Medical Records
1000 N. Lee Ave.
Oklahoma City, OK 73102
Fax to: 405-231-8897
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 405-272-7400
Fax to: 405-610-1354
Questions?
Call: 405-610-8084 (Monday-Friday, 8 AM – 4:30 PM)
Email it:
ssmhealthintake@mrocorp.com
Mail to:
SSM Health St. Anthony Hospital - Shawnee
ATTN: Medical Records
1102 W. Macarthur St.
Shawnee, OK 74804
Fax to: 405-878-8162
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 405-878-8160
Mail to:
SSM Health St. Anthony Hospital - Oklahoma City
ATTN: Medical Records
1000 N. Lee Ave.
Oklahoma City, OK 73102
Fax to: 405-231-8897
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 405-272-7400
Request Medical Records via Mail, Fax, or Email
If you are requesting medical records from a facility in the St. Louis metro area, please use the Authorization for Use and disclosure of Protected Health Information form found under each facility.
If you are requesting medical records from a medical group location - including medical group offices located on hospital campuses - in the St. Louis metro area, please follow the directions found under the Medical Group tab.
Questions?
Navigate to your SSM Health facility to find contact information for a medical records representative.
Missouri & Illinois Office Locations
If you are requesting your medical records from your primary care or specialty physician office located in the Greater St. Louis area (Missouri) or in the Metro East (Illinois), use this form to complete your request. In processing this request, you will be asked to validate your identity and give authorization for your record’s release.
Other Inquires/Third Party Requests
If you are requesting medical records as a third party or prefer to speak to someone over the phone, please call 610-994-7500 to speak to our vendor MRO for more information and to make your request.
Or, download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health Physician Groups
Attn: Health Information Management
7980 Clayton Road, Suite 350
St. Louis, MO 63117
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
Health Information Management
1465 S. Grand Blvd.
St. Louis, MO 63104-1095
Fax to: 314-268-6473
Email it:
ssmhealthintake@mrocorp.com
Questions? Call: 314-577-5600, ext. 1419 or toll-free 800-366-6119, ext. 1419
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health DePaul Hospital
Attn: Health Information Management
12303 DePaul Drive
St. Louis, MO 63044
Fax to: 314-344-6598
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 314-344-6295
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health St. Clare Hospital - Fenton
Attn: Health Information Management
1015 Bowles Ave.
Fenton, MO 63026
Fax to: 636-496-4906
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 636-496-2570
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health St. Joseph Hospital - Lake Saint Louis
Attn: Health Information Management
100 Medical Plaza
Lake Saint Louis, MO 63367
Fax to: 636-625-5419
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 636-625-5325
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health St. Joseph Hospital - St. Charles
Attn: Health Information Management
300 First Capitol Drive
St. Charles, MO 63301
Fax to: 636-947-5258
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 636-947-5362
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health St. Joseph Hospital - St. Charles
Attn: Health Information Management
300 First Capitol Drive
St. Charles, MO 63301
Fax to: 636-947-5258
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 636-947-5362
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health Saint Louis University Hospital
Attn: Health Information Management
1201 S. Grand Blvd.
Saint Louis, MO 63104
Fax to: 314-257-7161
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 314-257-7160
Download and complete the Authorization for Release of Protected Patient Health Information form.
Mail to:
SSM Health St. Mary's Hospital
Attn: Health Information Management
6420 Clayton Road
Richmond Heights, MO 63117
Fax to: 314-768-8853
Email it:
ssmhealthintake@mrocorp.com
Questions?
Call: 314-768-8133
Request Medical Records via Mail, Fax, or Email
If you are requesting medical records from a facility in Wisconsin, please download and complete the Authorization for Use and disclosure of Protected Health Information form. For any questions, please call 833-588-5382.
Mail form to:
SSM Health Hospitals
Attn: Health Information Management
420 East Division Street
Fond Du Lac, WI 51935
Email it:
ssmhealthintake@mrocorp.com
Mail form to:
SSM Health Dean Medical Group Health Information
Attn: Release
P.O. Box 259840
Madison, WI 53725-9840
Fax it:
Attn: Release
610-879-3704
Email it:
Email your completed form to ssmhealthintake@mrocorp.com
Questions?
Call: 833-588-5382
Mail form to:
SSM Health Monroe Hospital, Health Information Management
515 22nd Ave
Monroe, WI 53566
Email it:
ssmhealthintake@mrocorp.com
Fax it:
610-879-3704
If you have questions please call one of our representatives at 833-588-5382.
Mail form to:
SSM Health Hospitals
PO Box 259840
Madison WI 53725-9840
Email it:
ssmhealthintake@mrocorp.com
Phone: 833-588-5382
Fax: 610-879-3704
Mail form to:
SSM Health Hospitals
PO Box 259840
Madison WI 53725-9840
Email it:
ssmhealthintake@mrocorp.com
Phone: 833-588-5382
Fax: 610-879-3704
Mail form to:
SSM Health Hospitals
PO Box 259840
Madison WI 53725-9840
Email it:
ssmhealthintake@mrocorp.com
Phone: 833-588-5382
Fax: 610-879-3704
Include Proof of Identification
SSM Health takes patient privacy very seriously. Therefore, a copy of the patient’s legal guardian's ID is required to request medical records. We need this identification to verify that you are authorized to request the patient’s records. This can be a state-issued ID, birth certificate, etc. If you have any questions about what type of ID is accepted, please contact HIM. Birth certificates must be acquired from your state’s Department of Health & Family Services.
Receiving Your Records
After the authorization form is filled out and received by our office we will provide a copy of your medical records. You can receive your records in a variety of ways including:
- By mail via the U.S. Postal Service
- MyChart
We do our best to expedite all requests, but in some instances it can take up to 30 business days to complete the request.