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Patients and Visitors

Request Medical Records

To request medical records, please print and fill out the applicable form below.

Request for Access to Protected Health Information: Please complete this form to have a copy of your medical records sent to you or to someone other than yourself. Note: Parents and guardians, please use this form for your patients.
 
Authorization for Release of Information: Third parties, please complete this form to request a copy of an individual’s medical records. Note: The individual whose records are being requested must sign this authorization.

Once completed, mail the forms to:

Christian Hospital 
Health Information Management 
ATTN: Release of Information 
11133 Dunn Road 
St. Louis, Missouri 63136 USA

Please note that a fee may apply.


Christian Hospital and Northwest HealthCare, members of BJC HealthCare, provide world-class medical care to the communities of North County, Greater St. Louis County and Southern Illinois.
 

 

For more information, call 314.653.5116 or 314.653.5113.

Hours
Monday through Friday
8 a.m. - 4:30 p.m.

Find a doctor or make an appointment: 800.392.0936
General Information: 314.653.5000
Christian Hospital
11133 Dunn Road
St. Louis, Missouri 63136


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