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Release of Health Information

If you would like a copy of your medical records, please download one of the following Authorization for Release of Health Information forms:

Instructions for completing the Authorization for Release of Health Information form (PDF)

Please be aware that there will no longer be an onsite HIM presence at the CentraCare - Willmar Lakeland Clinic starting Monday, November 14, 2022. If you need to request your records, you can either:

  • Call Release of Information at (320) 231-5014 and follow the prompts.
  • Request your records via MyChart.
  • Obtain an Authorization for Release of Health Information (above) and return the completed form to the corresponding location on page 2.
  • Visit the HIM department onsite at either:
    • CentraCare - Rice Memorial Hospital (attached to the Willmar Lakeland Clinic via the tunnel on the Lower Level) OR;
    • CentraCare - Willmar Clinic located at 101 Willmar Ave SW, Willmar, MN 56201