MercyOne Des Moines Medical Records

Paper Copy of Medical Records

To request a copy of your medical records for MercyOne Des Moines, MercyOne West Des Moines or MercyOne Central Iowa Clinics, follow the steps below.

1. Print the form:

• Hospital records form
• Clinic records form

2. Return completed form:

• Hospital form:  Fax to:  515-633-3851, or mail:  Attn: Medical Records, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA 50314
• Clinic form: Fax to:  515-358-6996, or mail: MercyOne Central Iowa Clinics Administration, 405 SW 5th Street, Suite F, Des Moines, IA 50309

Please note -- include the patient’s signature and date of signature, located at the bottom of the form. If the patient is unable to sign, please provide the appropriate legal documentation needed to prevent any delays in retrieving records.  

Fees:

• There is no charge for records sent directly to a provider or other health care facility for the purpose of continuing care.
  
• If requesting records for personal or other use, a fee may be charged. Please contact us at the above phone numbers for more information.
  

Have Questions?

• Hospital records questions, please call 515-633-3915 from 8 a.m. to 4:30 p.m.
• Clinic records questions, please call 515-358-6918  from 8 a.m. to 4:30 p.m.