Do you need to access your medical records, get a copy of your birth certificate, or obtain duplicates of MRI scans? West Suburban Medical Center supports such requests three ways. Either use our Patient Portal, send us a message, or complete this form.
Official birth records are kept by the Cook County Clerk in the vital records department. Use this link to access their website, find their locations, or get a phone number.
Release of Medical Records
Medical records are private. In order to release your records to another person or organization, please print and complete the Records Disclosure Authorization Form and bring it to West Suburban’s Medical Records Department, or fax the completed form to (708) 383-3863.
Who can Authorize Release of My Medical Records?
- Your legally authorized representative (they will need a legal documentation)
- The parent of a patient under 18
- For a deceased person, authorizers include:
- Person assigned Power of Attorney for Health Care, with copy of Death Certificate
- Executor of the estate
- Special administrator
- Next of Kin, with notarized Small Estate Affidavit (available from Records Department).
How much does it Cost for Copies of my Health Information?
There is no charge for releasing your records directly to another health care provider. However, there is a charge for releasing copies of medical records to you (or your representative). This information can be found on the State of Illinois Comptroller’s website.