Request Medical Records
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.
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.
Print these forms, complete them and mail them to:
Barnes-Jewish St. Peters Hospital
Health Information Management
ATTN: Release of Information
10 Hospital Drive
St. Peters, Missouri 63376 USA
(These forms are in PDF format and require Adobe Acrobat Reader. If you don't have this software, go to Adobe for a free download.)
If you have questions, call 636.916.9694 between 8 a.m. and 4 p.m. Monday through Friday.
Please note that a fee may apply.