Patient Privacy

At the Hannibal Clinic, we take the extra steps to make sure your privacy is secure. Below are our privacy practices as well as a copy of the HIPAA release form to have your records released with your authorization.

Privacy Practices

Authorization for Release of Medical Records

Medical Records Authorization Forms

Request Medical Records Online

This form is used for requesting a copy of your health information for your own use or for transferring of records. Instructions to complete the form will print with the release form or contact us at 573-231-3196 to speak with one of our team members. Thorough completion of the form will expedite the record request process.

Hannibal Clinic now offers an online records request tool that verifies your identity by asking for a photo of your driver's license, which can be taken via webcam or smartphone. There is no additional charge to use this service.

Please note, Chrome, Safari and Firefox are the recommended browsers for this application.

Alternatively, we offer several other options to deliver your medical records, including:

  • Secure Email (our fastest option): Please call us at 573-231-3196.
  • Fax: 573-231-3705
  • Mail
    • Attn: Medical Records
      PO Box 311
      Hannibal, MO 63401
  • In Person
    • Completed form may be brought to any of the patient registration desks Monday-Friday, 8:00 a.m.-4:30 p.m. 

Patients may be charged a flat fee of $6.50 (plus postage if mailed for delivery) for records.

Transferring to Another Provider 

Records can be emailed, faxed or mailed to a provider of your choice. Please let us know your appointment date so we can arrange for records to be delivered timely.

Records are also available via our online Patient Portal.

Contact Us

  • Via Phone:        573-231-3196
  • Via Email:        Please call us to make arrangements
  • Via Fax:          573-231-3705
  • Via Mail:         Attn: Medical Records
                             PO Box 311
                             Hannibal, MO 63401

Our office is available from Monday-Friday, 8:00 a.m.-4:30 p.m. Pickup locations are available at the 2nd Floor Registration at 100 Medical Drive, Hannibal, MO 63401.