Release of Health Information

Notice! Due to the COVID-19 (Coronavirus) outbreak CentraCare Health Information Management (HIM) departments will be closed to the public effective immediately.

Individuals may submit completed and signed authorization forms to us through mail, fax or by email at CentraCareRecordRelease@centracare.com.

Records will be returned through MyChart when possible or through alternative means as indicated. Patient pickup will not be available at this time.

If you need a copy of your medical records, please fill out the Patient Request for Health Information. The second page of the form includes submission instructions.

• Patient Request for Health Information (PDF)
• Patient Request for Health Information in Somali (PDF)
• Patient Request for Health Information in Spanish (PDF)

If a third party has requested your medical records, please complete an Authorization for Release of Health Information form. If needed, you also can download and view instructions for completing the Authorization for Release of Health Information form. (PDF)

Download and print the appropriate Authorization for Release of Health Information form in PDF.

• CentraCare (PDF)
• CentraCare - Monticello (PDF)
• Midsota Plastic Surgeons (PDF)