Requesting Copies of Medical Records
The Children’s Mercy Health Information Management department maintains medical records for our patients.
Join the MyChildrensMercy Patient Portal to stay connected with your child’s health care team and access personal medical information anytime online.
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MyChildrensMercy Patient Portal Information Document (pdf) (en Español)
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Authorization for Patient Portal Age 0-17 (pdf) (en Español)
How to Request Medical Records
Parents and legal guardians may request the release of their child’s medical information by filling out an authorization form. The authorization must be signed by the patient's legal guardian or the patient, if the patient is 18 years or older. Authorizations must be dated within one year of receipt and are good for up to one year until completed. Once a valid authorization is received, we will respond to your request within 30 days.
Pertinent Information
There is no charge for receiving pertinent information. Pertinent documentation includes all documentation pertaining to doctors' diagnoses, test results and treatment for the last two years.
Payment for Complete Medical Record
There is a charge for receiving a complete medical record. All charges are listed in the table below.
How record is stored | How record is released | Fee |
EMR | CD or email | Labor for copying + supplies (CD) + postage = fee |
EMR | Paper | Labor for copying + supplies + postage = fee |
Hybrid (paper and EMR) | CD | Labor for copying + supplies (paper & CD) + postage = fee |
Paper | CD | $24.85 base fee + $0.57 per page = fee MO state fees (Section 191.227, RSMo effective 2/1/17) |
Paper | Paper | $24.85 base fee + $0.57 per page + fee MO state fees (Section 191.227, RSMo effective 2/1/17) |
Labor |
Fee |
Copying | $12 (based on average labor costs for copying to fulfill standard access requests) |
Supplies | CD: $1; Paper: $2 |
Postage (waived if records are picked up) |
Small envelope of only discs: $2 Large envelope: $7 Box: $10 |
FedEx | Actual cost |
HIPPA Authorization Third Party Request
Labor | Fee |
Records provided in any format | $24.85 base fee + $0.57 per page $108.88 max for records on disc MO State Fees (Section 191.227, RSMo effective 2/1/17) |
All Requestors
Item | Fee |
Radiology disc | $20 per disc |
Photos on disc | $5 per disc |
Payment
The Health Information Department will mail you an invoice before mailing the medical record request. You may pay by cash, check, money order or credit card to the Children's Mercy cashier located at each CMH location.
If copies are to be mailed to a doctor, hospital, or school, there is no charge.
Forms
Patients, parents or legal guardians may request copies of medical records by using one of the release forms listed below.
If you want Children's Mercy to send medical records to another organization, use the following forms:
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Authorization for release of medical information by Children's Mercy (pdf)
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Authorization for release of medical information by Children's Mercy - Spanish (pdf)
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Authorization for release of behavioral health information (pdf)
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Authorization for release of behavioral health information - Spanish (pdf)
If you want another organization to send medical records to Children's Mercy, use the following forms:
Contact Us
Adele Hall Campus
Phone: (816) 234-3455
Fax: (816) 302-9899
2401 Gillham Road, Ground Floor
Kansas City, MO 64108
8 a.m. -5 p.m.
Monday-Friday
Kansas
Phone: (913) 696-8085
Fax: (913) 264-9982
5808 W 110th St
Overland Park, KS 66211
7:30 a.m. - 4 p.m.
Monday-Friday
West
Phone: (913) 233-4400
4313 State Ave
Kansas City, KS 66102