Medical Records/Privacy

You will need to send a written authorization form, signed and dated by you, to our Health Information Management Department. An authorization form is available for you to print by clicking here.

There is no charge if the copies are going to another health care provider for your continued treatment. For other uses, there is a fee of $18.40 plus 61 cents per page. This fee is set by the Kansas State Legislature and is updated on a yearly basis.

This is a notice that we are required by federal law to give you the first time you obtain health care services from us. It tells you how we will use your protected health information and your rights concerning the use of that information.

Yes. If you wish to restrict the use of your protected health information, please let the representative know during registration. They will give you the correct forms to complete. If we can accommodate your request without compromising your care, we will.

On admission, you will be given a code number. Anyone who knows that code number can call the nurses and receive an update on your condition. If they do not know the code number, we will not release any information about your medical condition.

Yes. If you do not wish anyone calling the hospital to know that you are here, just let the representative know during registration. They will give you the correct forms to complete.