If you’d like us to release your personal medical records, print the Information Request–Patient Authorization form and mail to:
Release of Information
901 E 104th Street, Mailstop 6N
Kansas City, MO 64131
- Instructions for Authorization Form (PDF)
- Information Request—Patient Authorization (PDF)
- Solicitud de Información – Autorización de Paciente (PDF)
Access for Family Members/Caregivers
Proxy access is when a family member or caregiver can view a patient’s protected health information (PHI). The access must be authorized by the patient and multiple parties may be given access.
Requests for adult-to-child (patient is age 0–11) or adult-to-teen (patient is age 12–17) access can be completed in a Saint Luke’s clinic, by calling 816-880-6036, or by completing the request form:
For adult-to-adult (patient is age 18+) access, they can fill out the authorization form for adult-to-adult in the mySaintLuke’s Patient Portal, or can complete the request form:
Completed forms should be sent to Saint Luke’s Health Information Management by email.
For general medical records questions, email firstname.lastname@example.org.
For proxy access for family members/caregivers, email email@example.com.