Obtaining Medical Records

Complete and Submit our Request Form

To request a copy of your/your child's medical record complete a request form and send it by email or fax to the number below.. Due to the large volume of requests and compliance regulations, production or copies of medical records are not immediately available.  As soon as we can complete your request, it will be provided or sent.

Authorization to Release/Obtain Patient Information (PDF)
Autorización para obtención/divulgación de información sobre el paciente (PDF) - Spanish

If you wish to make your request in-person or pick-up your records in-person, please call ahead to the department so that appropriate arrangements can be made for a safe visit. This may result in a delay in fulfilling your request. If you pick up a copy of the medical record in person, we will ask for photo identification.

Inpatient & Outpatient Services

Send the completed form to Health Information Management (HIM) for the inpatient and outpatient services below:

  • Inpatient services provided at the Philadelphia or King of Prussia Hospital Campus or Children's Seashore House, including Emergency Department visits and stays lasting 23 hours or longer or
  • Outpatient services provided at Urgent Care Center, Same Day Surgery, Children’s Seashore House (i.e., occupational or physical therapy, speech, rehabilitation) send the form to:

Health Information Management Department
3500 Civic Center Blvd
Suite P1180
Philadelphia, PA 19104

Email: HIMROI@chop.edu
Telephone: 215-590-3640
Fax: 215-590-4193
Fax: 267-426-8654

 

To request information about outpatient services (i.e., doctor visits, blood tests) provided at the Philadelphia or King of Prussia Hospital Campus,* send the form to the department where service was provided or call 215-590-1000 to reach the appropriate department.
*If a test was ordered by a physician who is not affiliated with Children's Hospital, please contact that physician directly.

To request information about services provided at Specialty Care Centers, send the form to the Specialty Care Center where service was provided.

To request information about services provided at Primary Care Centers, send the form to the Primary Care Center where service was provided.

To request information about X-rays or other radiological images, including CT scans, MRIs and ultrasounds (radiological images are released on CD), send the form to:

The Children's Hospital of Philadelphia
Radiology Department
Radiology File Room
3401 Civic Center Boulevard
Philadelphia, PA 19104

Email: RRA@email.chop.edu
Telephone: 215-590-1000
Fax: 215-590-4783

To request information about inpatient or outpatient mental health records, please send the form to:

Email: BRADLEYA5@CHOP.EDU
Fax: 215-590-5052
Telephone: 215-590-7337

In order to complete your request for mental health records, the form will need to be completed in its entirety, please remember the following:

  • Form must include patient’s name, date of birth, and home address
  • Under section 3, you must initial next to mental health or your request will not be fulfilled
  • If the patient is 14 years old or over, the patient will need to sign and initial the authorization.

If you have any questions please contact via email for fastest response.t

Medical Record Copy Fees

There may be a fee for providing copies of the medical record:

  • $1.70/page (1-20 pages)
  • $1.26/page (21-60 pages)
  • $0.44/page (61+ pages)
  • $2.51/page Microfilm copies plus actual postage
  • $6.50 - CD

MyCHOP

The information you are requesting may be available free of charge through CHOP’s patient portal, MyCHOP. With a MyCHOP account you can view: test results, immunizations, visit and admission summaries, appointment information, medications, notes as well as a patient’s medical history. Please note: The portal only provides access to portions of the electronic medical record, it is not an all-inclusive medical record. To set up your MyCHOP account, contact your doctor's office and request a MyCHOP access code. Already have an account? Log in here.

You can also submit a medical record request in your MyCHOP portal by navigating to the questionnaire section

To Change a Patient's Name

To request a change to a patient name, please provide the required information in the link below:

Please note one of the required legal documents below must be submitted:

  • Patient’s birth certificate
  • Application for patient’s birth certificate
  • Patient’s driver’s license
  • Adoption decree for the patient
  • Patient’s Social Security card
  • Patient’s passport
  • Patient’s state-issued identification card
  • Legal documents, such as a court order, containing the patient’s name
  • A U.S. Permanent Resident card
  • Patient’s military identification card
  • For patients from countries other than the United States, a form of official identification from the home country