Request Medical Records
How To Request Your Medical Records
Are you a Riverside MyChart user?
- Log into your MyChart account.
- Click the “Health” icon (file folder with a small red heart) near the top left of the Home page.
- Select “Request Medical Records” from the Medical Tools section
- Complete all required fields on the “MyChart Request to Release Medical Records”
- Click the [Continue] button at the bottom of the screen
- Review the next screen, if changes are needed
1. Click the small pencil at the far right of any section you’d like to change
2. Make necessary changes
3. Click the [Jump to Review] button at the bottom of the screen - Click the [Submit] button at the bottom of the screen
Not a MyChart user?
Consent to Release Medical Records needs to be completed to begin this process. Please complete the form and return it as instructed below. Alternatively, you may stop by the Release of Information office in the Schneider Outpatient Center on the Pavilion’s first floor on the hospital campus, Monday - Friday, 8:00 am - 4:30 pm. Please allow a minimum of seven days turnaround for copies once we receive the completed consent form.
Download Consent to Release Form
Instructions for Completion of Consent to Release Medical Records
PLEASE LEGIBLY PRINT ALL INFORMATION YOU ENTER ON THE FORM (except signature)
- Enter the name, birth date, and last four digits of the social security number of the patient for whom you are requesting medical records in Section “A” to ensure that we search for the correct patient
- Enter the name of the person who is authorizing the release of these records (the person who will be signing the consent form) on the line marked “B”
- Enter complete mailing information for the individual to whom medical record copies should be sent in Section “C”
- Enter the date range for which you request medical records on the line marked “D”; Riverside Medical Center follows a ten-year retention schedule for medical records. Records from CY 2007 to the present should be available
- Mark the box(es) of the document(s) you are requesting in Section “E”; if the selections listed do not meet your needs, mark “Other” and clearly describe the documents you are seeking
- Enter the reason you’re requesting medical records on Line “F”
- Sign and date the form on Line "G"
- If you are not the patient, complete Line "H"
- Return the completed form to:
Riverside Medical Center
Health Information Management Department
ATTN: Release of Information Area
350 N. Wall Street
Kankakee, IL 60901
Or Fax the form to (815) 935-7863
Medical record copy fees for patients:
Medical record copy fees for all others (e.g., attorneys, insurance companies):
Electronic format (on CD): pricing is half of what is listed above - please indicate on the consent form if you’d like your record copies on CD Postage & shipping Actual cost if mailed/shipped
Payment is required when the copies are picked up in the Release of Information Office. If copies are being mailed, record copies totaling $10.00 or less will be mailed with a bill for this service. An invoice will be mailed to you before we mail the copies if record duplication fees total more than $10.00, and the copies will be mailed once payment is received. Please contact our Release of Information Center at (815) 935-7256 Ext: 38304 if you have any other questions or want to discuss this process with our service representative.
How to Amend Your Medical Record
If you believe the information in your medical record is incorrect or outdated, you can submit a written request to amend your Protected Health Information (PHI).
Please download and complete the Amendment Request Form for Medical Records and follow the instructions included in the document. Once completed, return the form and supporting documentation to the Chart Correction Unit via mail, fax, or email as indicated.