To Request An Individual Patient’s Records for a Third Party:
Patients and Third Parties, please complete the Authorization for Release of Information form to request a copy of an individual’s medical records to be released to a third party individual or institution. Note: The individual patient whose records are being requested must sign this authorization.
Completed Centerpointe Hospital forms may be returned in person, fax, by mail or email to:
4801 Weldon Spring Parkway
St. Charles, MO 63304
(636) 896-9679 | Fax: (636) 477-2132