Fort Memorial Hospital
611 Sherman Avenue East
Fort Atkinson, WI 53538
(920) 568-5000 | La linea de mensajes: (920) 568-5001

Medical Records online

Health Information Management

(920) 568-5188

Monday - Thursday 8:00 a.m. to 5:00 p.m.
Friday 8:00 a.m. to 4:30 p.m.

611 Sherman Avenue East
Fort Atkinson, WI 53538

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Contact Us:

Susan Kufahl

Email

Please call or visit the HIM department for all routine requests. If you have a compliment or concern, please feel free to email Susan.

Medical Records online

About Health Information Management

Health Information Management (medical records) is vital to providing quality patient care and the safeguarding of your health information. By monitoring access to health records, insuring proper maintenance and processing patient health information, we keep your records confidential. HIM also manages the coding and transcription of medical records. This includes acquiring, analyzing and protecting digital and traditional medical information.

Obtaining Your Medical Records

To get copies of your medical records for your personal use, or to have your records sent to someone other than you or your doctor, please complete an authorization form and provide photo ID as proof of identification.

Complete this form to have your records sent to a health care provider. You may also ask your provider to request your records for you. Include the appointment date on your request when needed for an upcoming doctor’s appointment.

Requests are normally completed within one week. When your medical records are not available or are incomplete, this may take longer .

Processing Costs

Fort HealthCare contracts with Ciox Health, a medical record copying service. Record releases processed by them will be sent by Ciox and billed accordingly (see fees). Medical records delivered through My Compass incur no charge. Learn more about My Compass online health records.

Copies of Radiologic Images

Please contact the radiology department at 920-568-5420.

Useful Forms

Fort HealthCare Authorization to Release Protected Health Information – (instructions included)

Medical Records Processing Fees

Request for Amendment of Fort HealthCare medical Record

Parental Consent for Treatment

Parental Consent for Treatment – Spanish