|How to Obtain Medical Records|
If you are a current patient in the hospital, you may ask your nurse to provide you with a request form authorizing the release of your medical information.
If you are not currently a patient, you may print and complete the appropriate form below releasing your medical record to either yourself or to a third party such as an attorney, caregiver or life insurance company.
The form must be signed by a person of authorization of the released information, such as the individual patient, parent or guardian, or personal representative.
Please mail the form to:
Health Information Department
If you have questions, please call our Health Information department at 308-398-5658.
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