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Request for Medical Records

The Medical Records office, located on the ground floor of the Hatch Wing adjacent to the elevator, is open from 8 a.m.-4:30 p.m. Monday through Friday.

Otherwise, please use one of the options listed below:

Continuity of Care: information needed for hospital or physician visits will be sent directly to the health care provider requesting copies of the information. Call (618) 463-7393 and someone will help facilitate the transmission of records​

Personal copies of medical records:

Call (618) 463-7395. A member of the HIM staff will be able to assist you

Download this authorization form Request for Access to Protected Health Information: and mail or fax to information below.

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.

Address:                                                          Fax #:  (618) 463-7193
Alton Memorial Hospital
Health Information Management
1 Memorial Drive, Room G-324

Alton, IL  62002                                                         

For all other Health Information Management related questions, please call (618) 463-7393 and someone will help direct your call. 

(The above forms are in PDF format and require Adobe Acrobat Reader. If you don't have this software, go to Adobe for a free download.)

Obtaining a Birth Certificate

Birth Certificates may be obtained from the Alton City Clerk’s Office. The address is 101 E. Third St., Alton, IL 62002, phone 618.463.3522. There is a $20 fee for a copy of the birth certificate. Please contact the City Clerk for further information.

Find a doctor or make an appointment: 618.463.7220 or 800.392.0936
General Information: 618.463.7311
Alton Memorial Hospital
One Memorial Drive
Alton, Illinois 62002

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