If you need a copy of your medical records, the Health Information Management Department (HIM) is available to help. Our office is open Monday through Friday: Window assistance 9:30 am to 1:30 pm and Phone Calls 8:00 am to 4:30 pm.
How to request records:
To request a copy of your medical records, please call us at 573-468-1358 or you may download and mail in an authorization form. If you choose to download, print and complete the form, you may mail or fax to:
Missouri Baptist Sullivan Hospital
Health Information Management
751 Sappington Bridge Road
Sullivan, MO 63080
Fax: 573-468-2687
Request for Access to Protected Health Information: Please complete this form to have a copy of your medical records sent to you or to someone other than yourself. Note: Parents and guardians, please use this form for your patients.
Authorization for Release of Information: Third parties, please complete this form to request a copy of an individual’s medical records. Note: The individual whose records are being requested must sign this authorization.
How long does it take?:
Some records are stored off-site and we may need additional time to obtain and copy them. We will do our best to prepare your records as quickly as possible, but please allow a minimum of two days for most requests. Allow two-four weeks for older records stored off-site. We ask that you call prior to coming in so we can start preparing your records and we can provide more specific information regarding length of time to obtain records.
How much will it cost?:
There is a charge of $0.52 cents per page for copying all records. When we have your records copied, we will contact you of their availability and the cost. If your physician needs a copy of your records, we can send a copy directly to your physician at no cost to you.
Birth Certificates:
Birth certificates are not available from Missouri Baptist Sullivan Hospital. To request a birth certificate, please contact your local health department (Franklin County Department of Health at 636-583-7300 or Crawford County Health Department at 573-775-2555). You may also contact the State of Missouri, Department of Health and Senior Services.