At Shriners Hospitals for Children, the health and safety of our patients, families, volunteers and staff is our top priority. With the evolving situation regarding COVID-19, we are closely monitoring updates from local health departments and the Centers for Disease Control and Prevention (CDC), and are actively following their recommendations.

If your child has an upcoming appointment, please contact your local Shriners Hospitals for Children location.

Shriners Hospitals for Children — Chicago visitor information – Updates

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Medical records and insurance

Medical records and insurance

Medical records

To request copies of your own medical records, or to authorize the disclosure of your medical records to another individual or third party, you will need to complete a HIPAA compliant form and submit your request in writing to the Health Information Services (HIS) department. Note: Please be sure to complete all sections when filling out the form.

Patients, legal guardians and personal representatives with legal authority to make health care decisions on behalf of the individual may obtain medical record copies by one of two methods:

  1. Completing a Patient Request for Information form: (English) (Español), or
  2. Submitting a request to release the medical record through the Shriners Hospitals for Children Patient Portal. (Note: This process does not require completion of the form listed above.)
    • If you already have access to the Shriners Hospitals for Children Patient Portal, see instructions here.
    • If you do not yet have access to the Shriners Hospitals for Children Patient Portal, contact the Shriners Hospitals for Children registration staff or care manager at this location to request an invitation.

To request a copy of your child’s medical records, please download and fax the completed form(s) to 773-385-5484.

You may also make a request by mail by sending a completed authorization form to:

Health Information Management
Shriners Hospitals for Children — Chicago
2211 N. Oak Park Ave.
Chicago, IL 60707

If you prefer, you may pick up an authorization form in person by stopping by the health information management office during our regular business hours: 8:30 a.m. – 4:30 p.m., Monday – Friday.

Requests for copies take 10 to 15 business days to process upon receipt of the authorization form. There may be a $1 per page charge depending on the size of the request.

Please use the above instructions to request medical records. For additional information call 773-385-5490.

To request a copy of your child’s medical records, please download and fax the completed form(s) to 773-385-5484.

Third parties may obtain medical record copies by submitting an Authorization for Disclosure of Health Information form that is completed and signed by the patient and/or legal guardian: (English) (Español).

Insurance questions

At Shriners Hospitals for Children — Chicago there are no barriers to care. Doctors determine the course of care, and all care is provided regardless of the families' ability to pay. The Chicago Shriners Hospital accepts many types of insurance, including Medicaid. If the child is covered by private insurance or a state funding plan, the hospital will bill and accept reimbursement for services provided at our hospital. Any child under 18 with a medical condition that is within the hospital’s scope of services is eligible.

For more information, or if you have additional questions, please call our financial counselor at 773-385-5450.