Release of Medical Information
Medical information is confidential and protected by law. While the information belongs to the patient, St. Croix Health owns the record. The information can only be released with authorization from the patient or their legal guardian. The law requires that the authorization include the patient’s signature and the date the request is being authorized.
St. Croix Health requires a completed and signed release of information form before releasing records. To request records please fill out the following online form.
If you prefer a paper copy to mail or far the form and instructions are linked below:
Return to St. Croix Health Release of Information:
Fax the completed, signed form to us at: 678-325-0317
Mail: Attention: Release of Information at the address listed on the bottom of the Release of Information Form (below)
- Release of Information Authorization Form
- Consent to Discuss Information with Providers
- Underage Consent Form
- Consent for Remote Provider Visit
Due to the cost of maintaining, retrieving, and copying records, there may be a charge for copies unless they are being sent directly to a healthcare facility. Upon receipt, we will process your authorization form for the release of your information. This may take three to five business days. If you have additional questions please email: grp.roi@scrmc.org or call (715) 483-3261.
If you are looking for immunization records both Minnesota and Wisconsin have systems that allow you to request this information.
Call us at (800) 828-3627 and we will help you obtain your medical records.
