The Health Information Management (HIM) department processes all requests for medical records for the hospitals, surgery centers, health centers and clinics listed on these pages.

Note: For more efficient processing of your record request, please include all facilities/locations on one request/authorization.

Follow these instructions for requesting medical records from Froedtert South.

MyChart

You may request your medical records through your MyChart account.

  • There is no fee for records released to MyChart. 
  • Records will be available in MyChart in seven to 10 business days.
  • If you do not have a MyChart account, you can "Request Activation Code" and "Activate Your Account" on the MyChart page.

Records Requests by Mail, Fax or In Person

If you are requesting records:

  • For yourself, or 
  • As the legal representative on behalf of your child or another person, 

Download the Patient Request for Medical Records or submit a signed and dated letter which includes:

  • Patient’s name (previous name(s), if there are any)
  • Patient's address
  • Patient’s date of birth
  • Preferred contact number (home phone/mobile phone) of the person making the request
  • Provider information from whom records are being requested; include the provider’s name and/or the name of the hospital, surgery center or health center/clinic that provided the service
  • The specific type of information being requested from the medical record; for example, the entire medical record for a specific date(s) of service or a specific note or test result along with the date
  • Name of person who will be receiving the information
  • Address of person who will be receiving the information
  • Format of records (paper, CD, MyChart portal or e-mail)

If you are a third party requesting patient records such as an insurance company or attorney:

  • Print the authorization form by clicking on hyperlink located below.
    Download Authorization Form
    Download Authorization Form (Spanish)
  • Complete all fields of the authorization form to prevent any delays in processing.
  • Check all Froedtert & MCW hospitals, surgery centers and/or Froedtert & MCW Community Physicians (clinics) on the form as appropriate.

Send the completed authorization or Patient Request form via U.S. Mail or fax, or drop the completed form off at any of the HIM (Medical Records) locations below. Once the authorization or Patient Request is received a determination will be made if payment is needed.

Froedtert Hospital

9200 West Wisconsin Avenue
Milwaukee, WI 53226-3596
Ph: 414-805-2909
Fax: 414-259-1244

St. Joseph’s Hospital

3200 Pleasant Valley Road
West Bend, WI 53095
Ph: 262-836-5057
Fax: 262-836-8470

Community Memorial Hospital

W180 N8085 Town Hall Road
Menomonee Falls, WI 53051
Ph: 262-257-3415
Fax: 262-253-7186

Community Physicians

110 Lone Oak Lane
Hartford, WI 53027
Ph: 262-836-2510
Fax: 262-836-8490

Cost for Obtaining Medical Records

  • Requestor: Hospital, clinic or providers for further care
    For upcoming appointments, include the date of appointment on request.
    No charge.
     
  • Requestor: Patient
    You would like a copy of your record for yourself or to go to someone who is not a healthcare provider.
    E-mail: $6.50
    Electronic record on a CD: $6.50
    Paper records: Refer to dhs.wisconsin.gov/wisact146/medical-records-fee.pdf for actual costs. A quote will be sent to indicate the total cost for copies that must be paid in full prior to records being released.
     
  • Requestor: Persons other than the patient and not a provider for further care
    Refer to dhs.wisconsin.gov/wisact146/medical-records-fee.pdf for actual costs. A quote will be sent to indicate the total cost for copies that must be paid in full prior to records being released.

When Will I Receive My Copies?

The time to process your request is seven to 10 business days.

If payment is needed, copies of medical records are released once payment is received. The following methods of payment are accepted:

  • Make payment online at https://track.recordjacket.com/TrackARequest.aspx enter the access code provided on the invoice.
  • Mail payment to Verisma Systems P.O. Box 556, Pueblo, CO 81002. Please make check or money order payable to Verisma Systems and document invoice on check. 
  • Make payment via credit card by calling the Verisma Office at 866-390-7404.

Requesting Medical Records from Froedtert South

If you are requesting records from Froedtert South (Kenosha Medical Center Campus, St. Catherine’s Medical Center Campus and/or the Froedtert South Medical Group locations in Kenosha, Paddock Lake and Pleasant Prairie) medical record requests are processed by Medical Records Department at:

Kenosha Medical Center Campus
6308 8th Avenue
Kenosha, WI 53143
262-656-2289

For more information, please visit froedtertsouth.com/Patients-Visitors/Patient-Privacy-and-Medical-Records.

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