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University of Chicago Medicine fax number
(708) 915-5675
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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
- 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.
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.
Sources and verification
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