Patients and Visitors

Clinical Information Services

Instructions for Medical Records Requests/Release of Information

All requests for copies of medical records must be received in writing. If the patient is a minor (less than 18 years of age), a parent or legal guardian must sign the authorization. Print a copy of the Authorization for Release of Protected Health Information (PDF format). This form must be completed, signed, dated and mailed or faxed to Clinical Information Services Department at:

Mercy Hospital
Attn: Release of Information Coordinator
500 E Market Street
Iowa City, IA 52245
Phone: (319) 339-3682
Fax: (319) 339-3785

Business hours: Monday – Friday 8 a.m. to 4:30 p.m.