FAQs
How can I view or obtain a copy of my medical record?
You have the right to view and/or request copies of your health care record. To view your health care record, you must make an appointment with the Health Information Management Department. (Photo identification is required.)
To obtain copies of your healthcare record, please download and complete the Authorization for the Disclosure of Protected Health Information form and send it directly to:
Bellin Health
Health Information Management
744 S Webster Avenue
Green Bay, WI 54305
Authorizations may also be faxed to (920) 433-7910
Can I obtain medical records on someone other than myself?
If you request records on someone other than yourself, you must provide legal documentation verifying legal guardianship, power of attorney, personal representative, etc. Biological parents may request copies of their minor child’s records as long as their parental rights have not been terminated. A completed authorization is required to obtain medical records on someone other than yourself.
Note: For billing information, please contact Patient Financial Services at (920) 445-7210.
How long does it take to obtain copies of my medical records?
It takes approximately 3-5 days to complete a request once it has been received. We realize there are circumstances when your medical record will require immediate disclosure. If this is your situation, please call Health Information Management to discuss your needs.
Is there a cost to obtain a copy of my medical record?
There is no charge for copies of your medical record if it is sent directly to another physician or healthcare facility. Records requested for any other reason may be subject to a processing fee. Please contact Health Information Management for more information.
Who can pick up my medical records?
If someone other than the patient will be picking up copies of medical records, that person must bring written authorization from the patient. Photo identification is also required when picking up medical records.
What if I find an error in my medical record?
If you feel that your medical records are incorrect or incomplete, you may ask us to amend that information. You have the right to request an amendment for as long as the information is kept by or for Bellin Health. If you are requesting an amendment to your medical record, please download, complete, and return this Request to Amend Form to:
Bellin Health
Health Information Management
744 S Webster Avenue
Green Bay, WI 54305
In certain cases, we may deny your request for an amendment of information: (1) was not created by us if the person or entity that created the information is no longer available to make the amendment; (2) is not part of the health information kept by or for Bellin Health; (3) is not part of the information which you would be permitted to inspect and copy; or (4) is accurate and complete.