need medicalrecords?

To get copies of your medical records, or to have information about your health sent to someone other than you or your doctor, you'll need to fill out an authorization form (below). If you need your records to be sent to a health care provider, you can either fill out this form, or contact them and ask them to request your records for you.

Sometimes there's a fee for medical record copies. If you've questions about fees, how long it will take to get copies, or other concerns, call your facility.

Find the phone number or address of your facility here.

Legally, Aurora Health Care can't answer questions about your medical records over email or online. And if you need records from more than one building or department, you need to send a request for each one, because each site maintains its own records.

What to know about the forms

Please don't leave anything blank on a form, as it can't be processed that way. That may mean delays for you.

Forms for download:

What you'll need to fill out in each section:

Your complete name, address, date of birth, daytime phone number and any previous names, in case you have older records under those names.
The name of the doctor, clinic or hospital that you're asking to release your information.
The person or place that you want to get your information. Check "SELF" if the records are going to you. If someone other than you will be picking up your records for you, please put that person's name here. And make sure you tell whoever picks up the records, whether it's you or a friend or family member, that they'll have to show a valid photo ID to get them.
Enter all the dates of the information you need, based on when you visited the doctor or had tests. If you're requesting all your records, you can just write in "ALL."

Check as many boxes as you need to cover what you're looking for. If you're requesting all the records for a certain episode, let us know which condition or treatment that is. If you need any help with this at all, please call the Health Information/Medical Record Department at your facility.

Not sure which documents are which? These lists may help:

Examples of hospital documents:

  • Discharge summary
  • Consultation
  • E.R. report
  • History/Physical
  • Operative report
  • Pathology report

Examples of clinic documents:

  • Physician visit notes
  • Occupational health exams
  • Medication list
  • Immunization list

Examples of home health documents:

  • Intake referral
  • Nurse or therapy notes
  • Medication list
  • Discharge summary

Examples of test results:

  • EKG
  • Lab
  • X-ray/imaging reports

If you don't want your mental health records, alcohol/drug abuse records or any HIV test results to be released (if you have these in your records), please note that here.

This is where you can let us know when you want this form to expire. You can write a date or an event.
Check whichever box or boxes is closest to the reason you're asking for this release of records. If none of the boxes apply, just check "OTHER" and write in why.
This section explains your legal rights. Remember that the person or place receiving your records may not be legally required to keep your records confidential.

If you're the patient, sign here. If you're the legal representative of the patient, you'll need to sign and also fill in:

  1. Your relationship to the person whose records these are.
  2. Your legal authority to act for the person in those records.
  3. If you are signing this form as a parent, you're declaring that you haven't been denied physical placement of your minor child by a court of law.

If you're mailing the form in, please address it to Medical Record Department – Release of Information. If you need to call to ask a question, ask for the Medical Record Department – Release of Information.

Additional facility phone numbers are available here.