Release of Health Information
Protecting your health information is important to us. It may be necessary for you to request copies of your health record. To do so, please complete an Authorization to Disclose Health Information Form (pdf). Please remember to sign and date the release form. Fax the completed form, along with a copy of your Driver’s License or other photo ID, to 320.231.4833 or mail to:
ATTN: HIS – Release of Information
Rice Memorial Hospital
301 Becker Ave SW
Willmar, MN 56201
If you have questions on the authorization process, please call the Health Information Services (HIS) Department at 320.231.4271 between the hours of 7am and 5pm
Frequently Asked Questions
The HIS Department is located on the lower level of the Hospital. Volunteers at the main entrance will provide directions or escort you to the Department.
You can choose to obtain your records via your MyChart account, on a CD, USB, or by mail or picking them up in person.
A patient’s first request for one year of medical records for their own personal use is free. There may be a charge for other types of records.
The specialist’s office will have you sign a form requesting your records from Rice Memorial Hospital, the records will be faxed directly to the specialist’s office.
If you send your spouse, significant other, child, in-law, friend or neighbor to pick up copies of your health information, we need a completed Authorization to Disclose Health Information Form (pdf) signed by you indicating written permission for this person to pick up copies of your health care information. The individual picking up your health information should also have a photo ID so we can verify their identity.
Proxy access to your children’s medical records can be established with MyChart, please refer to the MyChart page for more information. Under most circumstances, a parent can authorize release and get copies of medical records for a child who is under age 18. The parent must complete and submit an Authorization to Disclose Health Information Form (pdf).
You can only obtain a copy with the patient’s signed authorization.
In Minnesota you can call any County Recorder’s Office Vital Records Division to obtain a copy of your birth certificate or contact the Minnesota Department of Health at www.health.state.mn.us