Request Medical Records

Authorization to Release Medical Records Forms

Medical Records - 507-646-1182. 

There are several different options for medical records, please choose the one you want and fill out the appropriate form and fax it in.

Authorization to Release Health Information - To send medical records to another health care facility from Northfield Hospital + Clinics, please fill out the form below.

Authorization ROI Form

Fax it to our Release of Information Vendor, Vital Records Control, at 312-836-7919. Any questions, call 507-216-0100 or email NEintake@vrcnetwork.com.

Authorization for Disclosure of Health Information Form - To have your medical records sent to Northfield Hospital + Clinics from another health care facility, please fill out the form below.

Authorization for Disclosure Form

Fax  it to 507-646-1192. Any questions, call 507-646-1182.