Access or Request Your Medical Records

OSF MyChart

Using OSF MyChart, you can view your medical records or request a copy of your medical records or specific medical information.

How to Request Medical Records Using OSF MyChart

Step 1: Log in to OSF MyChart
Step 2: Click on Your Menu at the top of the page
Step 3: Click on Request Medical Records under the Sharing section of the menu
Step 4: Choose which facility you are requesting information from in the drop-down menu and complete the form

Once the form has been submitted and your request has been approved, your documents can be downloaded from the Document Center located in the menu under the My Record section.

Sign up for MyChart

For Patients of OSF HealthCare Saint Katharine Medical Center, Formerly KSB Hospital in Dixon, Illinois

To request medical records for services provided OSF Saint Katharine Medical Center (formulary KSB Hospital) use one of the options below.

Patient Portal: Patient Portal Sign-in

Phone: (815) 285-5424

Fax: (815) 285-5871

Email: SKMC.ROI@osfhealthcare.org

Forms:

• REQUEST for ACCESS to PROTECTED HEALTH INFORMATION (PHI) - Printable Form
• Authorization for Release of Medical Information – Printable Form 

Special Request & Authorization Forms

Third-Party Authorization Form

If you are a third party and have been authorized to request medical records, you will need to submit an authorization form along with your request.

Third Party Upload 

 

Request Medical Records from an OSF Medical Group or Ambulatory Care Setting

If you would like to request records from a doctor’s office visit, please call the office directly. Find your office’s phone number easily by visiting our location directory and searching for the office.

The quickest way to request your medical records is by requesting them through OSF MyChart or by using the online forms linked above. However, if you cannot use those options, you can send your request via email or fax using the contact information at the bottom of this page.

Request Medical Records from Substance Abuse Programs

You will need to complete specific authorization forms to request medical records from OSF Saint Anthony’s Health Center Inpatient Substance Abuse program and SFMC Medication Assisted Recovery Clinic. Once forms are completed, they can be sent via email, fax or mail or hand delivered to the facility. 

OSF Saint Anthony’s Health Center Inpatient Substance Abuse Program
SFMC Medication Assisted Recovery Clinic Authorization Form
OSF Saint Anthony's Health Center Inpatient Substance Abuse Program Counseling Notes
SFMC Medication Assisted Recovery Clinic Counseling Notes

 

PHI Request Attestation Form

Per the Final Rule of the HIPAA Privacy Rule to Support Reproductive Health Care Privacy, when a covered health care provider receives a request for PHI potentially related to reproductive health care, they are required to obtain a signed attestation that the use or disclosure is not for a prohibited purpose. This attestation requirement applies when the request is for PHI for any of the following:

• Health oversight activities
• Judicial and administrative proceedings
• Law enforcement purposes
• Disclosures to coroners and medical examiners

OSF HealthCare Reproductive Attestation Form
Law Enforcement Request for Release of Protected Health Information

Family Access to Medical Records

Your loved ones – including family or friends – may view your medical records through OSF MyChart.

You may authorize their access by going to OSF MyChart, clicking Your Menu and selecting Sharing Hub or by requesting proxy access. Learn more about Family Access.

How to Obtain Medical Records of a Deceased Relative

Executor of the Estate

An executor of the estate may request medical records by providing proper documentation including executor paperwork and a death certificate. You will need to submit the documentation to the medical records department of the location you are requesting records from.

Health Care Agent on Power of Attorney Form

The person named as a health care agent on a Power of Attorney form must also have the section checked that allows it to remain valid after death. A copy of the Power of Attorney form needs to be included with your request and sent to the medical records department of the location you are requesting records from.

Authorized Relative Certificate Form

Download this form to certify you are the surviving spouse, adult son or daughter, parent, or adult brother or sister of the deceased. You will need to submit this form with a copy of the death certificate and an authorization form to request medical records for the deceased patient.

Request a Status Update on Your Medical Record Request

OSF HealthCare partners with Verisma to assist with the release of information. Please contact Verisma using our OSF HealthCare dedicated line at (309) 205-6977.

Request a Change to Your Medical Record

Pursuant the Privacy Act of 1974 (5 U.S.C. § 552a (d)), an individual can request an amendment of his or her own record, providing the record is inaccurate, irrelevant, untimely or incomplete.

Please choose the hospital that provided the care from the list below to download the Request for Amendment form PDF. Follow the instructions on the form to submit.

• OSF Heart of Mary Medical Center (Urbana, IL) 
• OSF Holy Family Medical Center (Monmouth, IL) 
• OSF Little Company of Mary Medical  (Evergreen Park, IL) 
• OSF Sacred Heart Medical Center (Danville, IL) 
• OSF Saint Anthony Medical Center  (Rockford, IL) 
• OSF Saint Anthony's Health Center (Alton, IL) 
• OSF Saint Clare Medical Center (Princeton, IL) 
• OSF Saint Elizabeth Medical Center - Ottawa (Ottawa, IL)
• OSF Saint Elizabeth Medical Center - Peru (Peru, IL)
• OSF Saint Francis Medical Center  (Peoria, IL)
• OSF Saint James - John W. Albrecht Medical  (Pontiac, IL) 
• OSF Saint Luke Medical Center  (Kewanee, IL) 
• OSF Saint Paul Medical Center  (Mendota, IL) 
• OSF St. Francis Hospital & Medical Group  (Escanaba, MI) 
• OSF St. Joseph Medical Center (Bloomington, IL) 
• OSF St. Mary Medical Center  (Galesburg, IL)
• OSF Divine Mercy Continuing Care Hospital (Peoria, IL)