The Health Information Management Department (HIM) provides copies of medical records related to the care and treatment provided at Thorek Memorial Hospital.
HIM does not provide copies of radiology film. Such requests should be directed to the Radiology Department at 773-975-6756.
To request a copy of your medical records please complete and sign the Authorization for release of information form. (The form is available in English or in Spanish.) You can either download the form or request on by calling 773-975-6813.
Please include the following information:
Patient’s full name
Date of Birth
Social security number (optional)
Date of service
Complete name and mailing address to send copies
The fee for patients to obtain copies of their medical records is postage plus the following charges: (735 ILCS 5/8-2001)
Number of Pages
Pages 51 and more
Records being sent directly to a physician or a healthcare facility are provided at no charge to the patient.
If you have questions regarding your request, please contact the HIM department at 773-975-6813, Monday – Friday, 8:00 AM – 4:00 PM (excluding holidays)
Please mail your request to:
Thorek Memorial Hospital Health Information Management Department 850 W. Irving Park RoadChicago Chicago, IL 60613-3098