We want to make it as easy as possible for you to get a copy of your medical record. There are several options below to make the process convenient. Please note that in compliance with state and federal laws, all requests must be submitted in writing, completely filled out and signed.
How to request your Deaconess medical record:
- Download the release form
- Stop by the Medical Records Department (Currently, no in-person visits due to COVID-19.)
- Have it mailed to you by completing the email form below
- Call us at 812-450-3618
On the form you will indicate how we should release the records - if you will pick up the records or if you would like us to mail them to you or your doctor. Please allow 5-10 days for requests to be processed.
There will be a nominal charge for copying. It is based on the amount of pages to be copied. However, if records are being sent to another physician, the fee will be waived.
Submit the Form
The completed and signed form may be mailed, faxed, emailed to Deaconess.MedicalRecords@deaconess.com
or delivered to Deaconess Midtown Hospital Medical Records Department:
Deaconess Midtown Hospital
600 Mary St.
Evansville, IN 47747
To request a birth certificate, please contact the Vital Records Section of the state or county health department where you were born. The Vanderburgh County Health Department
Vital Records Section can be reached at 812-435-5814
MediCopy (FMLA and Disability)
MediCopy is a health information management company that has partnered with Deaconess to provide accurate and timely delivery of Disability/FMLA forms. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations regarding your protected health information.
How to submit your MediCopy form:
- Download MediCopy Intake form.
- Deliver your form(s) to your healthcare facility. Your form(s) will then be sent to MediCopy for completion. Please allow one business day before calling to make payment or check status.
- Forms are $30 for the first form and $15 for each additional form turned in at the same time. MediCopy will send an invoice, forms cannot be completed prior to payment. Please provide an email address if available as this will expedite the process.
- Once payment is received, MediCopy will complete your form(s) within three business days and sent to the requesting party. Forms will be completed based on information in your chart.
- If you have any questions, please contact MediCopy at 866-587-6274.
Questions about medical records, contact us 812-450-3618.