Requesting a Copy of Your Medical Records


You can sign up for Henry Ford MyChart which allows you to review your medical history (lab, test results, current immunizations, preventive care and medical/surgical history) on a secure line, free to use and available 24 hours per day.

Accessing your medical records

To request a copy of your medical records, please print and complete the Patient Information Release Authorization. The form must be completed in full - incomplete forms will be returned unprocessed.

The Patient Information Release Authorization should be signed and dated. Only the patient, the patient's legal guardian, the parent of a minor patient or the personal representative of a deceased patient may sign. If the patient is not signing, a copy of the Letters of Authority as Legal Guardian or as Personal Representative must accompany the form.

Please mail your signed patient authorization to any of the following Henry Ford locations listed below. A separate authorization must be completed for each medical record request. Requests should be directed to the facility where care was delivered.

Henry Ford Allegiance Health
Attn: Health Information Management
205 N. East Avenue
Jackson, MI 49201
Henry Ford Hospital and Health Network
Attn: Medical Records
2799 West Grand Blvd.
Detroit, MI 48202
Henry Ford Macomb Hospitals
Attn: Medical Records
15855 Nineteen Mile Road
Clinton Township, MI 48038
Henry Ford West Bloomfield Hospital
Attn: Medical Records
6777 West Maple Road
West Bloomfield, MI 48322
Henry Ford Wyandotte Hospital
Attn: Medical Records/HIM Dept.
2333 Biddle Ave.
Wyandotte, MI 48192

Looking for records from a hospital that later joined Henry Ford Health System?