To request a copy of medical records for care received at Eskenazi Health, please complete a Patient Medical Records Access Request Form (also available in Spanish and Haitian Creole). Please print the form, fill out the requested information and either mail, fax or email your handwritten form. If you would like to complete this form electronically instead, please open the "Online Medical Records Requests" dropdown and use the link to the online records request tool.
Mail, fax or email your completed form to Eskenazi Health Information Management (HIM):
Eskenazi Health
Attn: HIM Release of Information Department
720 Eskenazi Ave.
Indianapolis, IN 46202
Fax: 317.880.0469
Email: ROIRequests@eskenazihealth.edu
Please note that email transactions are not encrypted and may be viewed by a third party.