Release of Health Information

New Form Required as of Nov. 4, 2024
Due to recent Minnesota law changes, in most situations, we are required to get your signed consent before we can share information about your care with family and friends. Would you like CentraCare to communicate to family members or friends about your health care? Please complete this form and return it to CentraCare.

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

• Authorization for Release of Health Information form (PDF):
  • English
  • Spanish
  • Somali
• Instructions for Completing the Authorization for Release of Health Information Form (PDF)

How to request a copy of your records

• From your MyChart account, navigate to the MyChart menu and select Sharing Hub from the Sharing submenu
• Download one of the authorization forms listed above. Completed and signed forms can be submitted the following ways:
  • Fax or mail the appropriate site listed on page 2 of the Instructions for Completing the Authorization for Release of Health Information Form.
  • Email your completed form to CCHROI@CentraCare.com.
  • Drop it off at one of the In-Person Release of Information locations below.

In-Person Release of Information Assistance

• Willmar: CentraCare – Rice Memorial Hospital
  Use the main entrance and ask for the Health Information Management (HIM) department at the registration desk.
• St. Cloud: CentraCare Plaza
  Use the Prairie East or West entrance. Take the elevator down to the lower level. Follow the hallway to the left. HIM Release of Information is the second door on the right.