Patients can request medical records using the electronic form on this page, the printable form, or the patient portal. Most requests are processed within 10 days per hospital policy.
Requesting your records
Complete all required fields on the electronic form below and sign before submitting. Provide accurate contact information, specify which records you need (for example, dates of service or “all records”), and indicate how you would like to receive them. There is no charge for requesting copies of your medical records.
Who can sign
- Adult patients sign their own requests, unless a legal representative is acting for them.
- Parents may sign for minor children under 18, and legal guardians should include guardianship papers.
- If you are a POA or executor for an estate, attach documentation showing your authority.
Patient portal
You can also access many records through the patient portal for yourself, minor children, or individuals for whom you are a legal guardian. To set up portal access, contact Cassey Lauer at (515) 462-2373, Ext. 296.
Printable form and submission
If you prefer paper, click here to download Authorization for Release of Medical Information . Print, complete, sign, and return the form with any required legal documents.
You can submit the printable form by:
Mail
Madison County Health Care System
Health Information Management
300 W. Hutchings St.
Winterset, Iowa 50273
Fax
(515) 462-1948
Please call the Health Information Management department with any questions.