Department of Health Information Management (HIM)
To request a copy of your child’s medical records from SSM Cardinal Glennon, the Authorization for Release of Protected Patient Health Information form must be filled out and returned to the Health Information Management (HIM) Department.
Call: 314-577-5600, ext. 1419 or toll-free 800-366-6119, ext. 1419
to have HIM send you a copy.
Download and print: the authorization form here.
Next, you need to fill out the form and send it to HIM.
Fax it: to HIM at 314-268-6473.
Mail it: to HIM at
Health Information Management
1465 S. Grand Blvd.
St. Louis, MO 63104-1095
After the Authorization form is filled out and received by our office we will send a copy of your child’s medical records via U.S. Mail. The medical records may also be picked up by making arrangements with HIM. It will take about 5-7 business days to complete the request.
You can sign up to view your child's medical records from your computer or any smartphone. Learn more about this free and convenient service for our patients.
Frequently Asked Questions
Do I need to send any sort of documentation along with the form?
SSM Health Care and SSM Cardinal Glennon take patient privacy very seriously. Therefore, a copy of the patient’s legal guardian's ID is required to request medical records. We need this identification to verify that you are authorized to request the patient’s records. This can be a state-issued ID, birth certificate, etc. If you have any questions about what type of ID is accepted, please contact HIM.
How long will it take for me to receive the records?
It will take 5-7 business days to complete the request.
How will I receive the records?
You can receive the medical records in one of two ways.
By mail: via the U.S. Postal Service from a company called Healthport
By picking them up in person: after making arrangements with HIM
Can I have the records sent along to someone else like his/her school, sports team, or specialist?
Yes. In the second section of the Authorization form, there is a place to indicate that you are authorizing SSM Cardinal Glennon to disclose the medical records to a third party.
If so, what information do you need from the third party: address, phone, etc.?
In the case of disclosing your child’s medical records to a third party, we would need the name, address, phone, and fax (if applicable) of the third party. We would also need the relationship of the third party to your child (school, physician’s office, etc).
Does it cost money to request my child’s medical records?
For personal requests, the cost is $.50 per page. For requests being sent to a third party (i.e. continued care, insurance companies, or legal counsel), the fee will be paid for by that third party. Please be sure the third party is properly listed in the second section of the Authorization form.
What sort of payment do you take?
A bill will be sent to you once the records request is complete. If you are responsible for the payment, you may pay over the phone, by cashiers check, credit card, or money order.
How can I be sure this is safe?
Providing correct information on the Authorization form is the first step in protecting your child’s confidential health care information. Be specific regarding the documents and dates that are to be released. Also, make sure any third party information listed on the Authorization form is correct; we will only release your child’s records to the parties listed on the form. We also use an encrypting method to ensure the security of your child’s private health care information.
If you have any other questions about requesting medical records from SSM Cardinal Glennon Children’s Medical Center, please contact Health Information Management at
314-577-5600, ext. 1419 or toll-free at 800-366-6119, ext. 1419.