Medical Records Request

You may request a copy of your med­ical chart for your­self or have your records trans­ferred to anoth­er med­ical provider.

Request Your Med­ical Record

• Down­load and com­plete the Autho­riza­tion for Release of Med­ical Infor­ma­tion Form
• Com­plet­ed forms can be mailed, faxed, or emailed to:

Quin­cy Med­ical Group
1025 Maine Street
Quin­cy, IL 62301
Fax (217) 223‑6944
roi@​quincymedgroup.​com

Deliv­ery

Quin­cy Med­ical Group will respond to your request with­in 30 days of our receipt of your request. If we require addi­tion­al time to respond to your request, we will con­tact you to inform you of this exten­sion of time. Please call as soon as pos­si­ble if you need records for an out-of-town appointment.

To check on the sta­tus of your request, please call (217) 222‑6550, ext. 3793.