Medical Records

Electronic Request for Records

CHI Memorial now offers an online patient record request tool that verifies your identity by asking for a photo of your driver’s license, which can be taken via webcam or smartphone. There is no additional charge to use this service. Please note: Chrome, Safari and Firefox are the recommended browsers for this application.

Request Records Electronically

To request a copy of your medical information in person or by fax, download, print and complete the “Authorization for Use or Disclosure of/Access to Protected Health Information” form (to authorize disclosure of records to another person or organization) or “Patient Access Request to Their Protected Health Information” form (to request access to own records).  You may bring the form to the CHI Memorial Medical Records Department (on the 1st floor of CHI Memorial Hospital Chattanooga), fax it to (423) 495-4740 or mail it to:

CHI Memorial
Health Information Services
2525 de Sales Avenue
Chattanooga, TN 37404

CHI Memorial Medical Records office hours are Monday - Friday, 8 a.m. - 4:30 p.m. at CHI Memorial Hospital Chattanooga. Records are usually available within 7 to 10 business days from the time the request is made. If you have any questions, call health information management at (423) 495-8285. 

Medical Record Copy Fees

  • For records sent directly to a provider or other health care facility for continuing care, there is no fee.
  • For patients only, below are the standard fees to produce a copy of your medical records.
    • Electronically maintained records delivered in electronic format $6.50
    • Electronically maintained medical records combined with paper records delivered in Electronic format are billed at $6.50 (for the electronic portion) + $0.07 per page (for the paper portion) for labor involved in creating an electronic copy of the records maintained on paper
    • Electronically maintained records delivered on paper are $0.90 for labor cost to create the paper copy of the record maintained electronically plus $0.05 per page for paper and toner
    • Paper records delivered in electronic format are $0.07 per page for the labor involved in creating an electronic copy of the records
    • Paper records delivered on paper are $0.12 per page
    • Plus, postage and applicable taxes