Medical Records

Medical Records

Medical Records

To request your or your child’s medical records, you need to fill out the Patient Request for PHI (PDF) form. The form must include a parent or guardian’s written signature to be complete.

You can send the completed form in one of these ways:

  • Fax: (414) 266-6316
  • Email: Attach the form and send it to MedicalRecords@childrenswi.org
  • Online: You can also request records through MyChart. Proxy and adult access forms are available on the MyChart page

If you’re a third party (such as an attorney or insurance company), you must send a completed and signed authorization form (PDF) from the patient, parent or legal guardian.

This authorization form (PDF) can also be used if a parent or legal guardian wants to:

  • Give permission to talk about medical information with certain people
  • Allow records to be shared with specific individuals for a set period of time

Children's Wisconsin Health Care Information Management Department:

(414) 266-2300

Children's Wisconsin Fox Valley Hospital

Outpatient:
Phone: (920) 969-7970
Fax: (920) 969-7979

Inpatient:
Phone: (920) 729-2164
Fax: (920) 729-2131

Get your Medical Records Through MyChart

With MyChart, you can: 

  • See your child’s medical records online
  • Order a full copy of their medical record for free
  • Safely manage and receive health information from your phone or computer

How to sign up for MyChart at Children’s Wisconsin:

  1. Ask your provider for an activation code, or request an activation code online
  2. Once you get the code, go to mychart.childrenswi.org
  3. You have 60 days to use the code and activate your account

MyChart is a secure and easy way to stay connected to your child’s care.

Learn more about MyChart’s benefits.