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Health Information Management


Will you send my records to my provider?


Ordering Providers will automatically receive results of their requested exam/test at no charge to you. You are also able to request a copy of your medical records for personal use by clicking on the Medical Records Request form below. Please complete the form and return it to CCMH to be processed. A valid State Issued ID will be required along with the Medical Records Request form for the release of medical records. CCMH has 30 days to process a request for medical records.

CCMH complies with both the State of Missouri RSMo Section 191.227 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) 45 CFR 164.524 in regards to fees charged for medical records. If your request is under 50 pages, CCMH will provide those records at no cost to you. For any request that is beyond 50 pages, CCMH contracts with ScanSTAT Technologies to copy and provide all medical records requested from our office. We reserve the right to charge the Medical Records fee as set forth in RSMo Section 191.227. Our current charge rate for requests in excess of 50 pages is $0.35 per page after page 50 plus $25.00.

For Medical Records requests under 50 pages, requests are faxed or mailed depending on the number of pages and failure of the fax number on the request. We generally do not fax records more than 50 pages. We will only fax to secured lines; we will not fax to a patient's homes. Please complete the Release of Information request accurately and clearly.

Can I get a copy of my deceased relative's records?


You can get a copy of the record if you are the executor of the relative's estate or if you are the power of attorney who has been caring for them.

Medical Records Request Form


Click here to print form. Or Complete our online form here. You can request medical records by completing the medical records request form. Health Information departmental staff will not interpret any lab result findings. If you have any concerns about your test findings, please contact the Ordering Provider or your Primary Care Provider.