The Cook County Department of Public Health only has medical/immunization records for people who received medical services or immunizations with our agency.
To request CCDPH medical records relating to health care, please download, complete and return one of the following forms. If you are requesting your immunization record, please select "Other" on the form and write in Immunizations.
- Release of Information Form, English
- Release of Information Form, Spanish
- Release of Information Form, Polish
Please Fax or mail the completed form to:
Cook County Department of Public Health
7556 West Jackson Boulevard
Forest Park, IL 60153
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: 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.