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Patient Resources

Your doctor has chosen Rush SurgiCenter for your upcoming outpatient procedure. And if you're like most people, you probably have a few questions about how to prepare and what to expect at our facility. This booklet was designed to give answers to many common questions and provide reassurance to you and your loved ones. A handy checklist of things you need to do related to your visit is included on the back panel.

The Rush SurgiCenter takes great care to protect your personal health information. This Notice of Privacy Practice describes how medical information about you may be used and disclosed and how you can get access to this information.

PDF Notice of Privacy Practice

The Rush SurgiCenter abides by nondiscrimination policies. The information below is a requirement of Section 1557 of the Affordable Care Act and is provided to help people who may need assistance with the English language or translation to a different language.



Request Medical Records

We want to make it as easy as possible for you to request copies of your medical records. In compliance with state and federal regulations, you must submit your request in writing.

How to request your records

  1. Download a form authorizing Rush SurgiCenter to release your health information, available here (PDF).
  2. Fill out the information on the form, indicating the records you are requesting and the specific date of your visit.
  3. Sign the form and send it to the address below:

Rush SurgiCenter
ATTN: Medical Records Department
1725 W. Harrison St., Suite 251
Chicago, IL 60612



Fee Schedule for Medical Record Requests

Rush SurgiCenter shall charge a fee for medical records which are not sent directly to another medical facility. There is no cost for records sent directly to another medical provider, hospital, clinic or doctor.

All patients requesting their records directly will be charged a flat fee of $6.50.

All other requests will be charged in alignment with the current fees as regulated by Illinois Code of Civil Procedure 735 ILCS 5/8-2001(d). The following are the current rates as published by the Illinois Comptroller (these rates are adjusted annually based upon the Consumer Pricing Index):

  • Handling Charge - $27.33
  • Copy pages 1 through 25 - $1.02
  • Copy pages 26 through 50 - $.68
  • Copy pages in excess of 50 - $.34
  • Postage for records which are mailed will also be charged if applicable

Please allow 7 to 14 days for processing.

If you have questions

Please contact the Medical Records Department with any questions.
Phone: (312) 563-2913