About Your Medical Records
At Rochelle Community Hospital, we are sensitive to the private nature of a patient's medical record. We take steps to assure that your medical records are kept confidential and secure.
We require a patient's written authorization or valid subpoena to release medical records for insurance purposes or legal reasons. These records are sent by mail and are not available by facsimile. The original records are kept at Rochelle Community Hospital, but you may request copies at any time once you have provided us with a written authorization.
Note: A separate authorization is required for each request.
How to Obtain Medical Records
You will need to fill out an "Authorization for Disclosure of Medical Record Information" form and return it with the appropriate fees to:
Rochelle Community Hospital
Completed Authorization forms can also be faxed to 815-561-3124.
For ease of reference, hospitals may be reimbursed for copies of medical records as follows:
Actual postage will be charged for all copies.
The first set of x-ray films or CDs is free of charge.
*Records being sent to a physician or a healthcare facility are provided at no charge to the patient.
VALID ID MUST BE SHOWN AT TIME RECORDS ARE PICKED UP.
You can either download the form from this website or you can call 815-562-2181, ext. 2740 to request a form. If the records are for a deceased patient, you must provide legal documentation showing power of attorney, executor of the estate or a death certificate showing next-of-kin to obtain records. A patient's spouse, relative or friend will not be able to pick up patient medical records without a written signed authorization from the patient, stating that the hospital may release records to the specific person. The person must be named in the authorization and proof of identification is required and the patient's signature will be checked for authenticity.
Rochelle Community Hospital has the right to refuse to honor a written authorization if there is reasonable doubt as to the identity of the person presenting the authorization or evidence that the person requesting the information is not the person named in the authorization.
If you are not requesting specific documentation, you will be sent an abstract that typically includes history and physical reports, discharge summary, operative reports, consultations, lab, X-ray, specialized tests and most recent outpatient visits.
Time to process requests:
For your information, the statutory reference is 735 ILCS 5/8-2001. The fees will be adjusted yearly.
Please contact our Correspondence Department at 815-562-2181, ext. 2740 for additional assistance.