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.


You may request your medical records through your MyChart account.

Records Requests by Mail, Fax or E-Mail

If you are requesting records, including radiology images:

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

Download the request form below.

OR you can 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)

NOTE: The security of e-mail transfers is not guaranteed.

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.

Froedtert Hospital

Attn: Health Information Management-ROI
9200 W. Wisconsin Ave.
Milwaukee, WI 53226-3596
Ph: 414-805-2909
Fax: 414-259-1244
E-Mail: [email protected]

Community Physicians

Attn: Health Information Management-ROI
110 Lone Oak Lane
Hartford, WI 53027
Ph: 262-836-2510
Fax: 262-836-8490
E-Mail: [email protected]

Holy Family Memorial Inc.

Attention: Release of Information
P.O. Box 1450
Manitowoc, WI 54221-1450
Phone: 920-320-2278
Fax: 920-320-5118
E-Mail: [email protected]

If you are requesting an EHI Export of your patient records, please contact Health Information at 262-836-6368.

When Will I Receive My Copies?

The time to process your request is seven to 10 business days. Froedtert Health has contracted with Verisma as our Business Associate for ROI purposes.

If payments are required, you will receive an invoice from Verisma.

Report a Deceased Froedtert & MCW Patient

Fill out the online form to report a deceased Froedtert & MCW patient.

Requesting a Birth Certificate

Please note, birth certificates must be requested through the state of Wisconsin, not from the Froedtert & MCW health network.

Requesting Medical Records from Froedtert South

Froedtert South locations include Froedtert Kenosha Hospital (formerly Kenosha Medical Center), Froedtert Pleasant Prairie Hospital (formerly St. Catherine’s Medical Center) and the Froedtert South Medical Group locations in Kenosha, Paddock Lake and Pleasant Prairie. Froedtert South medical record requests are processed by Medical Records Department at:

Froedtert Kenosha Hospital
6308 8th Avenue
Kenosha, WI 53143

For more information, please visit