Medical Records Request

To obtain a copy of your medical records, please return a completed copy of the medical records authorization form. If you have not yet completed an authorization form, please download and print the form, download it here. If records for a partner are also needed, please submit a separate authorization form.

Signatures must be either a physical (wet) signature or completed using DocuSign after downloading the form.

Email the completed form to fcimedicalrecords@fcionline.com or fax to 847-486-7074.

The standard processing time for medical records requests is up to 30 days from the date the request is received.

If your request is urgent, please email it to fcimedicalrecords@fcionline.com and include “EXPEDITED” in the subject line. We will do our best to accommodate your needs. Please note that additional fees apply for expedited requests.

Once we are ready to process the request, we will send you a payment link. We kindly ask that you do not pay any fees online or in the clinic without us reaching out to you.

The normal turnaround time to receive copies of records is 30 days. If you needed expeditated records, please make sure you put “EXPEDITED” when you submit the form, and then pay the additional expedited fee (when we send you a payment link). We will do our best to accommodate your specific turnaround needs.

Your Medical Records and Your Privacy

Ensuring patient confidentiality is a top concern of Fertility Centers of Illinois. To learn more about this, read our Notice of Privacy Practices.