Request Your Records
Download and complete this form to authorize the release of your health information.
The law requires that the authorization include the patient’s or guardian’s written signature along with the date the request is being authorized.
Submit Your Form
DROP OFF Any Clinic Location
FAX (715) 318-5644
MAIL Medical Records
NorthLakes Community Clinic
15954 Rivers Edge Dr.
Hayward, Wisconsin 54843
Records Delivery Schedule
While we process all requests as quickly as possible, please allow up to 30 days for your medical records to be transferred due to our high volume of requests.
Review Your Records
Your medical records are available to review through our MyChart secure online patient portal.
Contact Medical Records
888.834.4551 push 2
If we miss your call, please leave a voicemail. Include your name, date of birth, and a brief message.
Understanding Your Medical Records
Your medical records are comprehensive files containing your health information that help healthcare providers deliver quality care and meet legal requirements. These records typically include:
- Medication lists
- Allergy information
- Diagnoses and medical conditions
- Immunization history
- Treatment summaries and care plans
- Visit notes and consultations
- Laboratory and test results
This information creates a complete picture of your health history, ensuring consistent and appropriate care across all your healthcare interactions.
Your Privacy, Rights & Authorization
By law, you can request access to your protected health information. NorthLakes will only share as needed for treatment, payment, or with your permission.