Click here to download Authorization for Release of Information. Please print the form and fill it out and sign.
You can sign for your minor children that are under 18 years old. If you have guardianship of a minor, please send appropriate guardianship papers with release.
If you are a POA or executor for an estate, we will need appropriate papers sent with release of information. There is no charge to request medical records. Per hospital policy, we have a 10 day turnaround.
You can mail, email or fax your completed release.
Mailing Address
Madison County Health Care System
Health Information Management
300 W. Hutchings St.
Winterset, Iowa 50273
Email Address
HIM@madisonhealth.com
Fax Number
515-462-1948
We do have a patient portal available for you to access medical records for yourself, minor children or if you are a guardian for someone. Please contact Cassey or Shelley for information on how to set up your patient portal.
Cassey 515-462-2373 Ext. 296
Shelley 515-462-2373 Ext. 298
Please feel free to call us with any questions.