To request the release of your private health records or to authorize care providers to share your personal health information with others, download, fill out, and submit the correct form of the two forms listed below
To request the release of your private health records, download, fill out*, and submit:
Authorization for Release of Protected Health Information (PDF format) to request copies of your records
Submit the completed form to the Fairview location where your care was received. At this time, hospital records are not available online or by electronic means. We apologize for any inconvenience. Call the number listed below to answer any questions you may have. Please be aware that our staff is not able to provide requested information to you verbally.
*Fill out the form completely. Incomplete requests cannot be processed.
To authorize care providers to share your personal health information with others, download, complete and submit:
Authorization to Discuss Protected Health Information - to request that care providers discuss your information with others
Fairview Lakes Medical Center
Health Information Management (HIMS) Dept.
5200 Fairview Blvd.
Wyoming, MN 55092
Release of Info Phone: 651-982-7875
HIMS General Phone: 651-982-7882
Wayfinding directions when picking up records at Fairview Lakes Medical Center
Medical Records/ Release of Information at Fairview Lakes Medical Center is located on the main level near the Intensive Care Unit (ICU). Use either the main entrance or the emergency entrance. Follow the signs to Medical Records/Release of Information. The service window is located in the hallway that leads to the ICU.