How to Request a Copy of My Records at WIHD

To obtain a copy of records, the patient will need to fill out a Consent for Disclosure of Protected Health Information (PHI) Form (also available in Spanish) or an equivalent to this document which gives permission for the person requesting to obtain the documents.

If the patient is a minor or is not competent to give consent, the signature of a parent, guardian or other legal representative will be required. Please note that in certain circumstances legal guardianship will require proof.

All requests must be made in writing.