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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.

Report a deceased Froedtert & MCW patient.

MyChart

You may request your medical records through your MyChart account.

  • There is no fee for records released to MyChart. Note: Imaging records cannot be released through 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 E-Mail

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)

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

Community Physicians

Attn: Health Information Management-ROI
110 Lone Oak Lane
Hartford, WI 53027
Ph: 262-836-2510
Fax: 262-836-8490

Email completed authorization form to healthinformation@froedtert.com.

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.
    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. Froedtert Health has contracted with ScanStat Technologies as our Business Associate for ROI purposes.

If payments required, you will receive an invoice from ScanStat Technologies.

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
262-656-2289

For more information, please visit froedtertsouth.com/patients-visitors/patient-privacy-rights-medical-records.

Requesting Medical Records from Holy Family Memorial Inc.

Medical record requests are processed at:

Holy Family Memorial Inc.
Attention: Release of Information
P.O. Box 1450
Manitowoc, WI 54221-1450
Phone: 920-320-2278 (You will need to leave a voice message.)
Fax: 920-320-5118
E-mail: roi@hfmhealth.org

For more information, please visit hfmhealth.org/release