Stockbridge-Munsee
Health and Wellness Center 

   Medical Records


Patient Privacy and Confidentiality is our priority.

Your privacy is important.  At the Stockbridge-Munsee Health and Wellness Center (SMHWC) your medical records are kept strictly confidential yet readily available when you need to share information with your health care team.

Who owns my medical records?

The physical health care record is the property of the Stockbridge-Munsee Health and Wellness Center and is maintained for the use of our Facility and Staff for the benefit of the patient.  The information contained in your medical records belongs to you, and you are entitled to access that information.

How do I request copies of or transfer my Medical Records?

You are welcome to request copies of your medical records at any time. Please read below.

  •  If you want your records forwarded to another health care provider, please contact our Medical Records Department for assistance.  The Stockbridge-Munsee Health and Wellness Center will cooperate with transferring your medical records to another health care provider at your request.  There is no fee to transfer your medical information to another health care provider.
  • You may also contact that clinic directly to have your records sent to avoid delays.
  • At times your health care journey will take you from the doctor’s office to a hospital or specialty practice.  If you are currently seeing a provider at the Stockbridge-Munsee Health and Wellness Center we want to make this process as convenient as possible.  We will transfer the necessary records to the hospital or specialty practice for you.
  • If you would like your records to be sent to a non-health care related entity (i.e. insurance company, attorney), the entity must request them directly from the Stockbridge-Munsee Health and Wellness Center in writing.
  • If you would like to request a copy of your immunizations, you can do so online:
  • Wisconsin Immunization Registry (https://www.dhswir.org/PR/clientSearch.do?language=en)

  • You can download the Authorization to Disclose Health Information Form

Request for Correction/Amendment– Fill out and submit this form if you think information in your medical record is inaccurate or needs to be revised.


Requests are processed in the order in which they are received, and processing times vary according to our volume. 

Is there a fee for requesting my medical records?

Charges

You can make an appointment to view your medical records at no charge.  If you wish to receive a copy of your records for your own use, you may be charged a fee for processing the request.  There is no fee for transferring your medical records directly to another health care provider. Charges for copies may apply and are subject to change per state laws. The charges below represent the current patient fees for medical record copies at the Stockbridge-Munsee Health and Wellness Center. Fees for record requests are payable in advance to the Stockbridge-Munsee Health and Wellness Center Billing Department.  Records will be processed once the fee has been paid.

Fee Charges

No fee will be charged for requests for immunization records.  There will be a fee of $5.00 minimal charge per patient request for records.  A fee of $0.50 per records face page or $1.00 per double sided record page will be charged for the first 50 record pages.  A fee of $0.25 per records page or $0.50 per double-sided records page will be charged for any and all pages requested after the first 50 pages.  A fee of $10.00 will be charged for each X-ray film copy request.  These charges are set in accordance with the SMHWC Policy #202MERE0001. 

Can my medical records be shared without my consent?

Yes. The law allows for exceptions and typically limits the amount of information that can be released under special circumstances.  Some examples would be in response to a medical emergency, workers’ compensation claim or your insurance company for payment purposes.

Do I need Proof of Guardianship or Power of Attorney for Health Care paperwork?

If you have legal documents signed by a judge showing you have custody of a minor child, you are permitted to receive copies of the child’s health information.  You may also have access to patient records if you have a legally signed document that lists you as the patient’s Power of Attorney for Health Care and the patient is declared no longer capable or able to make their own health care decisions. Copies of such documents must be on file at our facility. 

Forms

Wendy Trinko


Medical Records Manager
Phone: (715) 793-5048
Email: wendy trinko

Fran Miller


Medical Records Clerk
Phone: (715) 793-5015
Email: fran miller

Michelle Miller


Medical Records Coding Technician
Phone: (715) 793-5103
Email: michelle miller

Angel Miller


Medical Records Clerk
Phone: (715) 793-5015
Email: angel.miller