Looking to obtain a copy of your medical records?

Terre Haute Regional Hospital utilizes CIOX Health for release of information. You may request the release of your medical records by printing and completing the following form:

Download Forms


Medical Records Release

English


Upon completion, choose one of the following options:

Mail

ATTN: CIOX Release of Information
7300 Beaufont Spring Drive - Boulders VIII- Parallon
Richmond, VA 23225

Fax

(855) 330-4290

Your medical records request will be filled within 7-10 business days, and we will inform you if we experience an unexpected delay. *Please note after the request is filled, delivery to your address may vary due to postal delivery times.

If you choose to receive your records by email, you should receive them much sooner.

For additional information, or to check on a status of a previous request please call (877) 302-7338 .

If you need translation services, please contact the facility Health Information Management (HIM) Department at: (812) 237-1604.

Additional Information

When records are to be released to another medical office for continuation of care, please specify the medical office name, address, phone and fax in the "Recipient" section of the authorization form.

For personal requests, your records will be sent to the designated address, fax or email provided on the authorization form.

For additional information or to check on the status of your request, please contact CIOX Health Customer Service at (877) 302-7338 .

To request copies of your bill or if you have a question about your bill please contact the billing office at (804) 267-4000.

If you would like to request a copy of radiology images on a CD, please contact the Radiology Department at Terre Haute Regional Hospital by calling (812) 237-1625.

Request for Amendment of the Medical Records

If you would like to make a request to amend your medical records, please complete the Record Amendment Request and mail it to the Facility Privacy Officer in the Health Information Management department at:

Terre Haute Regional Hospital

Attn: Health Information Management
3901 South 7th Street
Terre Haute, IN 47802

Downloadable Record Amendment Request (PDF)

Any other needs, please contact the Health Information Management office at:

Terre Haute Regional Hospital
3901 South 7th Street
Terre Haute, IN 47802

Phone (812) 237-1604