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  • Authorization Form - Froedtert Hospital

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Medical College of Wisconsin Froedtert Hospital 10000 Innovation Drive, Ste 300 Milwaukee, WI 53226 Ph: 414-955-5489 Fax: 414-955-6606 9200 West Wisconsin Avenue Milwaukee, WI 53226-3596 Ph: 414-805-2909.

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Contact support

In order to obtain your medical records, you should send a written request via certified mail to the last known address of the physician (you can find a physician's last known address on their Practitioner Profile).

MyChart is a free, easy and secure way to view your health information and communicate with your health care team. All you need is internet access and e-mail. You can also take MyChart with you wherever you go by downloading the Froedtert & MCW app.

A physician or physician's assistant must maintain a health care record on every patient. The records must be kept for at least 5 years... Treatment records (for mental illness, and drug/alcohol abuse) must be retained for 7 years after the treatment has been completed.

Campus Phone Call 414-805-5505 to connect with a live operator 24 hours a day for patient directory, department inquires, location directions and other general hospital information.

This Adult Proxy Request Form (this “Form”) is to be completed by an adult patient (the “Patient”, “you” or “your”) who is 18 or over and can make (and understand) the Patient's healthcare decisions and wants to give another person (a “Proxy”) the right to access Patient's information available through the MyChart ...

To request your medical records, contact us at (262) 836-2510 or via the Froedtert website.

Obtaining your Medical Records To do so, you must submit your request in writing to Froedtert South, Inc., Medical Records Department at 6308 Eighth Avenue, Kenosha, Wisconsin 53143. If you request a copy, it must be requested in advance and we may charge a fee for the cost of copies, postage and/or other supplies.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232