McKinley Health Center - Release of Medical Records
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Notice of Privacy Practices


Updated: September 2010

Release of Records


Requesting copies from your McKinley Medical Records

To request information from your McKinley medical records, you must submit a written authorization for release of your records. 

Click here for a printable copy of McKinley’s Authorization for Disclosure of Confidential Health Information form. Complete all sections of this form and mail or fax the form to:

McKinley Health Center
Medical Records Department
1109 South Lincoln Avenue
Urbana, Il 61801

Fax: (217) 244-6495

Important Note: The following information will not be released from your records unless specifically authorized by you on the form:

  • HIV/AIDS information as defined by Illinois Statute.
  • Alcohol and/or drug abuse treatment information protected under 42 Code of Federal Regulations.
  • Mental health records as defined by the Illinois Mental Health and Developmental Disabilities Confidentiality Act. Requests for mental health records also require a witnessed signature.

To specifically authorize release of records including the information listed above, check the appropriate boxes on the McKinley authorization form. 

Release of the requested information could take up to 2 weeks. Please indicate specific deadlines if the information is needed sooner, i.e. you have an appointment with a non-McKinley provider, need immunization records for school registration, etc.

You may call the McKinley Medical Records Department at (217) 265-0798 if you have further questions.


Requesting copies of records from another provider:

You may use McKinley’s Authorization for Disclosure of Confidential Health Information form to request that another provider send records to your provider at McKinley. Click here for a printable copy of the form; complete all sections and mail or fax the form to your provider.

 

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