To request CCDPH records relating to Health Care (including immunizations or WIC services), Mental Health, Alcohol and/or Drug Abuse, or HIV/AIDS condition, please:
Download and read instructions and form carefully, then complete and return the Release of Information Form to the local district office via fax. (See instructions for district office fax number).
- Release of Information Form, English
- Instructions for completing Release of Information Form, English
- Release of Information Form, Spanish
Please allow 3 to 5 business days for a copy to be made. Some records may take longer if they need to be retrieved from an off-site record storage facility.
Please note: The Cook County Department of Public Health only has medical/immunization records for people who received medical services or immunizations with our agency. CCDPH does not keep records of immunizations administered by other providers. If you are a resident of the City of Chicago, please contact the Chicago Department of Public Health.