How to request copies of your medical record:
Go to the Health Information Management office on the main level of Liberty Hospital, down the hall behind the information desk (toward Subway). To help facilitate the process, you can print and complete the Authorization for Release Form prior to your visit. *This form must be completed, signed and returned.*
Typically, there is no fee for this service; however, certain cases may require a fee.
If you are physically unable to visit the hospital's Health Information Management department, please send a written request for your records, along with the signed Authorization for Release Form to: Health Information Management, Liberty Hospital, 2525 Glenn Hendren Drive, Liberty, MO 64068.
You may email the signed form to firstname.lastname@example.org.