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University of Chicago Medicine fax number

(708) 915-5675

Health Information Management Office (Medical Records Dept., MC0978)

Used for: Medical records release / Release of Information (ROI) requests

Fax destination details

Department
Health Information Management Office (Medical Records Dept., MC0978)
Purpose
Medical records release / Release of Information (ROI) requests
Form
ROI Authorization for Medical Records — University of Chicago Medicine Health System Authorization Form
Address
5841 S Maryland Ave, Chicago, IL 60637
Voice phone
773-702-1637

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.

Download the ROI authorization form, complete sections I–V (patient information, records requested, recipient), sign, and submit by mail or fax to the Health Information Management Office.

Official form instructions are published as a downloadable file on the organization's website.

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