Health Information Management

How to obtain copies of Medical Records from St.Vincent Indianapolis, Carmel, or Women's Hospitals

A written authorization is required for the release of records. The authorization may be mailed or submitted in person Monday through Friday between 8:00 a.m. and 5:00 p.m. to:

Health Information Management
Attn: Release of Information
St. Vincent Indianapolis Hospital
2001 West 86th Street
Indianapolis, Indiana 46260
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If the request is submitted in person, picture identification is required

The copying fees consist of a labor charge of $20.00 which includes the first ten (10) pages of records, 50¢ per page for pages 11-51 and 25¢ per page for pages 51 and greater. Other charges may apply for postage, stat requests or certifications.

(The facility must be specified, Indianapolis, Carmel, or Women's or state that records are being requested from all.)
 

Guidelines for signatures

1. The patient, if eighteen years of age or older, or, if under eighteen, is emancipated or married.
2. The guardian of a patient in a minority (i.e., under eighteen years of age) if legally appointed.  Proof of guardianship is required.
3. The parent having custody of the patient, if the patient is under eighteen years of age, is unmarried, and is under parental control.
4. If a person is under eighteen years of age, is unmarried and is not in the custody of a parent or legal guardian and is a neglected child, then by the agency of which the child has been made a ward of the Juvenile Court.
5. If the patient is found incompetent for a reason or reasons other than minority, then by the court-appointed guardian; or, if he has been committed to an institution, then by the superintendent of such institution;
6. The personal representative (executor or administrator) of the deceased patient’s estate; or, if there is no personal representative, the spouse, or if none, an adult child.
7. The appointed health care representative, provided that evidence of such appointment is received which describes the personal representative’s authority to act for the individual.
   

NOTE:  If information concerns a minor treated primarily for drug and/or alcohol abuse, consent need only be given by the minor.

Request for Information Form (pdf) 

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