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Medical Information Release

Consent form

If you need a copy of your health information (medical record) for any reason, you must make your request in writing on a HIPAA compliant authorization (consent) form and forward to:

Health Information Management (Medical Records)

St. Anthony's Medical Center

10010 Kennerly Road

St. Louis, Missouri 63128

Or, you can print out and fax the form to Health Information Management at 314-525-1972.

For additional information, please contact us at 314-525-1239.