Your Medical Record
To obtain a copy of your Deaconess Hospital medical record you must submit a completed and signed release authorization form, as follows:
Get the Form
To get a blank release form, you may:
- download it online by clicking here
- stop by the Deaconess Hospital Medical Records department (map) or
- have it mailed to you by emailing us
- call us at 812/ 450-3618
Submit the Form
The completed and signed form may be mailed, faxed, or delivered to Deaconess Hospital Medical Records department:
600 Mary Street
Evansville, IN 47747
FAX: 812/ 450-3995
There will be a nominal charge, based on the amount of pages to be copied. However, if records are being sent to another physician, the fee will be waived.
On the form you will indicate how we should release the records - if you will pick the records up, or if you would like us to mail them to you or your doctor. Please allow 7-10 days for requests to be processed.
To request a birth certificate, please contact the Vital Records Section of the Vanderburgh County Health Department at 812/ 435-5814. For more details, visit them online