Medical records information

To request your/your child’s medical records, you must complete and send in the Patient Request for PHI (PDF) form. A form is not complete unless a parent or guardian's written signature is on the form. You may fax the completed form to (414) 266-6316 or email it as an attachment to MedicalRecords@childrenswi.org. You may also request medical records using MyChart. Find the proxy access and adult patient forms on the MyChart page.

If you are a third party requesting patient records (i.e. attorney or insurance company), please submit a completed authorization form (PDF) signed by the patient/parent/legal guardian.

The authorization form (PDF) may also be used for patient/parent/legal guardian who wants to provide authorization on file to exchange PHI verbally with certain individuals or to have release of PHI on file to specific individuals for a duration of time.

Children's Wisconsin healthcare information management department

(414) 266-2300

Children's Wisconsin-Fox Valley

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

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

Get your medical records through MyChart

MyChart lets you view your child's medical records online, or you can order the complete record for free. It's a secure way you can help manage and receive information about your child’s health electronically.

To create a MyChart account at Children's Wisconsin, you can request an activation code online or request one from your provider. Once you have the activation code, you have 60 days to go to mychart.childrenswi.org and activate your account.

Learn more about MyChart’s benefits.