Medical Records


How do I obtain a copy of my personal medical record?
To obtain copies of your personal medical record you must complete an authorization form as well as the acknowledgement of fees form as some fee will apply.

Request Medical Records

Please fill out the Authorization for Release of Patient Health Information and Acknowledgment Fees form. You may choose to mail it or fax it:

Attn: Health Information Management
Greenwood County Hospital
100 W. 16th
Eureka, KS 67045 Fax: 620-583-6821


You may hand-deliver the forms to the Health Information Department.

Any questions you may have about your medical record request, please call Medical Records, Monday through Friday 7:00 am -4:00 pm at 620-583-7451.

Calls are returned within 1 business day. Physicians, other healthcare facilities and organizations requesting records may also call the above number.

Authorization for Release of Patient Health Information and Acknowledgment Fees Form


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