Request Your Medical Records - Jesse Brown VA Medical Center
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Jesse Brown VA Medical Center


Request Your Medical Records

COVID-19 UPDATE: In an effort to promote social distancing, download the following forms to request medical records. Forms may be submitted by mail or fax:

Fax Number: 
(312) 569-8039 

Jesse Brown VA Medical Center
Attention: Release of Information
820 S. Damen Avenue
Chicago, IL 60621

If you have any questions, please call the Release of Information Office at 312-569-7700 

Our Release of Information staff will be happy to assist you with requests for your medical records. We also assist providers with completing forms for patients.

We can assist you with the following —

  • access to your medical records
  • obtaining copies of your medical records

The Release of Information Staff is expert in our patients' rights and their medical records.

Please call 312-569-7700 to speak to someone in the Release of Information Office.

How to Request Information

To request a medical record, please use one of the forms listed in the column to the right, complete the requested information, sign the form, and mail it to the following address —

Jesse Brown VA Medical Center
ATTN: Release of Information (PAS)
820 South Damen
Chicago, IL 60612

Because forms must contain an original signature, e-mailed forms cannot be accepted.

Requests for records will take approximately 10-14 days to process.