Medical Records Request
You may request a copy of your medical record by printing and completing an authorization form which allows us to release the information to you. Mail the completed form to:
Health Information Management Department
Community Memorial Hospital
PO Box 408
Menomonee Falls, WI 53052-0408
The form must be filled out completely in order for us to process it. The copies will be mailed to you. We do not fax the copies because of security and privacy issues.
Download Authorization Form
In order to view PDF files you will need the Adobe Acrobat Reader, which is available for free, from Adobe’s web site.
Schedule an Appointment
If you want to come to the hospital to review your medical record, call 262-257-3400 to schedule an appointment. Appointments must be made at least 24 hours prior to the review. The review shall take place in the Health Information Management Department between the hours of 8 a.m. and 5 p.m., Monday through Friday, excluding legal holidays.