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Request for Medical Records

In an effort to keep our patients and employees safe during the COVID-19 outbreak, the Health Information Management offices will be working remotely until further notice.

Please use one of the options listed below:

Continuity of Care: information needed for hospital or physician visits will be sent directly to the healthcare 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 Dr.   Room G324

Alton, IL  62002                                                         

For all other Health Information Management related questions, please call (618) 463-7393 and someone will help direct your call. While our local offices are closed, our staff is still available to help support you during this time.  Together, we are prepared to provide continued service to allow you to take care of yourself, your patients and your families.

(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: 800.392.0936
General Information: 618.463.7311
Alton Memorial Hospital
One Memorial Drive
Alton, Illinois 62002


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