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Garfield Park Behavioral Hospital fax number
(773) 265-4375
Medical Records Department
Used for: Release of Medical Records (ROI) requests
Fax destination details
- Department
- Medical Records Department
- Purpose
- Release of Medical Records (ROI) requests
- Form
- Release of Information (ROI) form — Release of Information Form
- Address
- 520 North Ridgeway Avenue, Chicago, IL 60624
- Voice phone
- 773-265-3700
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill out patient name and date of birth, requester name and address, purpose of disclosure, specific information requested, and dates of service. Sign and date; requests can be returned in person, via fax to 773-265-4375, or by mail to Garfield Park Behavioral Hospital, Attention Medical Records Department, 520 North Ridgeway Avenue, Chicago, IL 60624. Processing may take up to 30 days; for urgent requests, document the required date. For questions, call 773-265-3700.
Official form instructions are published as a downloadable file on the organization's website.
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