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Patient Medical Records

State Statute 146.81-.83 allows you the right to your healthcare records. Under this law, after you have signed an Authorization for Disclosure of Health Information, you may:

  • Inspect your healthcare records during regular business hours upon reasonable notice;
  • Receive a copy of your records upon payment of the cost of reproduction.

This law also permits your healthcare records to be released without your consent to other persons or organizations, who are required to keep the information confidential. Examples of this type of release include:

  • To healthcare personnel working under the supervision of a physician, if they are assisting in your care, consulted about your care, or for record keeping or billing purposes;
  • Upon the order of the court;
  • To medical review committees, hospital staff committees, etc., in order to review the quality of care being rendered;
  • In the event of a legally authorized request by a governmental agency or researcher. If you are not a Medicare, Medicaid or other governmental assistance recipient, you may refuse to permit release to these governmental agencies and/or researchers by annually completing a form prepared by the Wisconsin Department of Health and Social Services.

All patient healthcare information at CHN is kept strictly confidential and protected by State and Federal laws, as well as HIPAA regulations.  Medical records can only be released with proper authorization from the patient or the patient's legally authorized representative.

You can request copies of medical records by submitting the appropriate authorization form below. If you have questions or require additional assistance, please call CHN Health Information Services (HIS) at 920-361-5912.

Authorization for Disclosure of Health Information

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