Request Medical Records
- Monday through Friday: 7:30 a.m. - 4:30 p.m.
- Closed on weekends and all major holidays.
Phone: (317) 329-2221
Fax: (317) 329-2531
To request a copy of your medical records, please fill out an Authorization to Release Health Information Form. Please make sure to complete all sections of the form and include your signature and the date. You will need to specifically identify what records you want (do not write "send all medical records"). If you need help filling out the form, please refer to this example or call the HIM office during office hours at (317) 329-2221.
Please be aware that submitting an incomplete or unsigned form may cause delays in processing your request.
Please submit the form in one of the following ways:
Send us your completed form via our fax number: (317) 329-2531.
Please send your completed form via mail using the following recipient and address:
The Rehabilitation Hospital of Indiana
Attn: HIM Department
4141 Shore Drive
Indianapolis, IN 46254
Please send your completed form to our email: firstname.lastname@example.org.