St. Louis Children's Hospital
Correspondence Center
One Children's Place
St. Louis, Missouri 63110 USA
Phone -- 314.454.6060, correspondence secretary
Facsimile -- 314.454.2032
Medical Records Request Form
Our Medical Recrods Request Form is an Adobe Acrobat (PDF) document. If you are interested in downloading this file, but do not have Adobe Acrobat, you can download the program now.
Thank you for your interest in obtaining your medical record. In order for St. Louis Children's Hospital to release confidential medical record information to you, please complete the request form available below, including your signature. We apologize, but we cannot accept e-mail requests, as a handwritten signature is required for us to release your record. Please print and complete the form and fax or mail it to the Correspondence Center.
There is a fee of 47 cents per page for photocopies if your record is still in paper form. If we must go through microfilm, there is a processing of $1.50 per page. You will receive a bill for our efforts with the mailed copy of your record. Before we begin researching and copying your record, we are happy to provide you a cost estimate.
To minimize cost, we suggest requesting a copy of:
- Discharge summaries
- Operative notes
- Diagnostic tests
- The "abstract" of the record which would give you the essential elements of the record without having all of the daily assessments
We can only provide you a copy of the information we have. We cannot interpret what the information means or discuss it with you. Please take the information to your personal physician to discuss the findings.