Record Request
If you are a client and want to see notes, lab results or other records the quickest way is to login to your healthcare portal account and download them yourself.
If you do not have a portal account setup yet, signup for one now
If you need to obtain records that you can not get on the portal or need a summary letter of your treatment, download and fill out this record request form. Fax the form in, drop it off or mail it back. Please be as specific as possible with the exact type of records and dates you need. If there are many pages of records to print you may be charged $25 for a processing fee. A few pages is free.
Clients, parents or their legal guardians must fill out the form, sign and consent. Records will not be released otherwise.
If someone other than the client needs to speak about the client’s care they can call 920-882-7780 after the client or legal guardian has given permission by signing this form.