
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 314-525-1238.
For information, please call our Health Access Line at 314-ANTHONY (268-4669) or 800-554-9550 or visit find a physician online.
At St. Anthony's, our vision is to be the area's premier health care organization
— and your first choice for health care services.



