Patients and VisitorsHow to Recieve a Copy of Your Medical RecordTo receive a copy of your medical records, you must complete and sign an authorization to release protected health information. (Click here for form) Please be sure to sign the form. Unsigned requests or incomplete forms can not be processed. FAX the request form to: 715-735-5491 OR EMAIL to: releaseofinfo@bamc.org and put Medical Records Request in the subject line. OR MAIL to: Your request will be processed and fulfilled within ten working days. We will either mail to the address specified or you may pick up your record at the address above between the hours of 7am and 5pm Central Standard Time, Monday through Friday. If picking up records, a photo ID is required. If someone else will be picking up your records, they must have written authorization to pick up your records and must also provide a photo ID. There may be a fee charged dependent on the request purpose. We will let you know by telephone how much the charge will be once we retrieve your records from our archives. We do provide pertinent information free of charge if requested records are to go to other care providers. Should you wish to contact the Health Information Management Department (Medical Records), call us at 715-735-4200 ext. 3195 or send us an email at releaseofinfo@bamc.org and put "Medical Records Request" in the subject line. Frequently Asked Questions
Permanent record storage is being maintained by a professional record storage company: Sourcecorp Record Center. Medical Record Requests can be made by contacting the release of information technician by phone at 920-469-5000 ext.3772 or 800-469-0689. Fax request at: 920-469-0689 or written requests at: 1030 Ontario Road, P.O. Box 8408, Green Bay, WI 54308-8408. Charges for these requests will be handled on a case-by case basis with each requester. Permanent radiology film storage is being maintained by Bellin Health / Oconto. |
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