If you are a new patient at Mayo Clinic Health System – Franciscan Healthcare, you will need to provide the following information upon registration:
All patients should arrive approximately 20 minutes prior to their appointment to allow time to complete the necessary forms. If you need to cancel an appointment, please call at least 24 hours in advance.
See our New Patients web section for additional information on being a new patient at Mayo Clinic Health System - Franciscan Healthcare.
Download and complete this form to request copies of your medical records or to provide us with your permission to share your medical records with another health care provider or system (make copies and send to them) or with another individual -- such as a family member -- who you wish to assist with your care. You will also need to use the same form to allow Franciscan Healthcare to discuss your billing/financial information with any other party.
Return the completed form to one of the following
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) can also 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. Monday through Friday and the telephone number is 608-392-6275.
Follow the instructions on this form to request a change to your medical record. The instructions tell you how to request changes and where to return the information.
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 Avenue South
La Crosse, WI 54601