Community Memorial Hospital - Staunton Illinois an Anderson Healthcare Partner
Community Memorial Hospital - Staunton Illinois an Anderson Healthcare Partner

 

Request Medical Records

 

 

Request Medical Records & Authorization Forms

Patients and legal guardians complete the Request to Access PHI Form and mail to the address above.

Send completed form to:
Health Information
400 N. Caldwell
Staunton, IL 62088

Authorization to Treat Minor

This form can be filled out by parents and guardians of children to give a designated person such as grandparents, babysitters, teachers, etc. authorization to have their child treated for medical emergencies.

Phone Numbers:
For more information, please call 618-635-4257. Fax 618-635-4354

 

 

400 N Caldwell Street    Staunton IL 62088    Phone: 618-635-2200
 

aaa