To get a personal copy of your medical records or to have your records forwarded to another party, we need you to complete an “Authorization for Disclosure of Protected Health Information” form. You can download a copy of the form in English or Spanish below, fill it out, and bring it with you to meet with our representative privately. To find the Medical Records office, please stop at the Information Desk in the Main Lobby and ask for assistance in requesting your medical records. You also need to bring your government-issued ID so that we can verify your identity before releasing the records.
If you have any questions or need further assistance, please call or fax the medical records department team.
- Phone: (574) 753-1390
- Fax: (574) 753-1515