Medical Records

Steps to request medical records

1. Fill out the Authorization for Release of Information. You can get a copy of the form by:

• • Picking one up in person or using the links below.

  • If you want Children's Mercy to send medical records to another organization, use the following forms:

    • Authorization for release of medical information by Children's Mercy (PDF)

    • Autorización para la divulgación de información médica por Children's Mercy (PDF)

    • Authorization for release of behavioral health information (PDF)

    • Autorización para la liberación de información de salud conductual (PDF)

  • If you want another organization to send medical records to Children's Mercy, use the following forms:

    • Authorization for release of medical information by an outside facility (PDF)

    • Autorización para la liberación de información médica (PDF)

1. • Calling (816) 234-3455 to have a form sent by email, fax, or mail.

2. If you are a patient over the age of 18: You will need to include a copy of a signed form of identification (like a driver's license or school ID) with the authorization.

3. If you are a parent of a patient over the age of 18: You will need to include a copy of legal documentation stating that you are the court appointed guardian of the patient.

4. Return the forms. You may:

   • Email them to ROI@cmh.edu

   • Fax them to (816) 701-4034 or

   • Mail them to Children's Mercy Health Information Management - 2401 Gillham Road, Kansas City, MO 64108

5. Your request will be processed within 30 days.

6. For fees and payment information, see our Charges for Complete Medical Records page.