Request copies of your medical records by downloading and completing this form. The form also can give your permission to share your medical records with another health care provider or system (you can make copies and send to them) or with another individual — such as a family member — who you wish to assist with your care. You also will need to use the same form to allow Mayo Clinic Health System to discuss your billing or financial information with any other party.
Return the completed form via one of these methods:
A central point where patients or their designees may view copies of their medical records is on the second floor of the La Crosse hospital building, near Desk 2A above the hospital main entrance. Both clinic and hospital records are available for viewing at this location. Patients or their designees also can sign authorization forms, pick up copies of their records and have other questions about records management answered. The office is staffed from 8 a.m. to 4:30 p.m. weekdays, or call 608-392-6275.
Request a change to your medical record. Follow the instructions on the form.
If you have documentation, such as a living will or health care power of attorney form or other information, you wish added to your record, you may drop it off in person at Desk 2A in the La Crosse hospital building or mail the documents to:
Health Information Department
Fourth Floor, St. Ann Building
Mayo Clinic Health System — Franciscan Healthcare
700 West Ave. S.
La Crosse, WI 54601