Click here to download a copy of the medical records request. Please print the form and fill it out and sign.
You can sign for your minor children that are
17 and under . If you have guardianship
of a minor please send appropriate guardianship papers with release.
If you are a POA or executor for an estate we
will need appropriate papers sent with release of information.
You can mail, email or fax your
Madison County Health Care
Health Information Management
300 West Hutchings
Winterset, Iowa 50273
If you have any questions please
call or email HIM department at 515-462-2373 and select option for Health
Information Management or you can email at above email address(s).
It is the policy of Madison
County Health Care System to have releases sent out within 10 days of receiving
a completed release of information.