Request Patient Records | UnityPoint Health - UnityPlace

Patient Records

For the convenience of our current and former patients, we are pleased to provide the ability to download forms you can use to request your medical records.

Request Records From Human Service Center

Simply download the PDF below and mail or fax your request to Human Service Center.

Patient Authorization for Release of Information Form

Patient Authorization for Release of Information Form (DUI Treatment Verification Records)

Mailing Address

Human Service Center
PO 1346 Peoria, IL 61654-1346

Phone Number

(309) 671-8005

Fax Number

(309) 671-8021

Frequently Asked Questions

  • All records are retained for 10 years, hospital records may be retained for up to 25 years based on state and federal requirements.
  • All Birth/Death Certificates must be requested through the County Courthouse. 
  • There may be minimal costs associated with certain types of requests.