Patients & Visitors
Medical Record Release
You must be 18 years of age or the parent/legal guardian to request copies of a medical record.
- Download and print Authorization Form PDF.
- Fill out the form as completely as you can.
- Be sure to include both the name and address that you would like your records released to.
- Be as specific as you can about the information that you'd like released (e.g., specific dates of service, specific treatment, just immunizations, etc.).
- Please mail your authorization to the address below and to the right.
- There may be a charge for copies of your medical records. If there is, we will notify you before copies are made. Once we receive your payment, your request will be processed.
Release of information authorization form.
Release of Information Phone and Fax Information
For Hospital Medical Records – 218.736.8479 or 218.736.8454; Fax 218.736.8757
For Clinic Medical Records – 218.739.6813 or 218.739.6690; Fax 218.739.6692
Record Release Location
Both Hospital and Clinic Health Information Management Services are located in the Business Services Center Building at 126 E Alcott in Fergus Falls.
Hours: Monday – Friday 8:00 a.m. – 4:30 p.m.