Patients and Visitors: Release of Information
To download a copy of the SCRMC Release of Information for Medical Records form:
You need to have the Adobe Acrobat Reader plug-in to view the release form. If you need to download Acrobat Reader, just click here.
Once you have Acrobat Reader you can access the release form by clicking on the link below.
Then print it out, complete the form and fax a signed copy to us at 715-483-0507
CLICK TO DOWNLOAD RELEASE FORM
Click here to download directions for Release Form if needed.
Please note, the release form may take a few minutes to download depending on your internet speed. Thank you for your patience.
Copyright 2016 St. Croix Regional Medical Center. All Rights Reserved