GWCH Medical Records, Eureka, KSRequesting Important Medical Records

Individuals

1. Complete the Applicable Form

To obtain copies of your personal medical records, you must complete the Medical Records Request Form. Please note that fees may apply.

For faster service, please use the online version of the Medical Records Request Form (online) link. Once you have submitted the online form, you will receive confirmation via email that we received your request.

Medical Records Request Form – (online)

To print a PDF version of the form instead, and return it to our department, use the Medical Records Request Form – PDF link below. If you choose this option, you will need to follow the directions in step 2 to provide the form to our department.

Medical Records Request Form – PDF

2. Provide the Form to Our Department

If you complete the PDF version of the form, you will need to provide it to the Health Information Management Department by one of the below methods: 

1. Hand-deliver the form to our department at the address below.
2. Mail the forms to our department (Attn: Health Information Management) at the address below. 
3. Fax the forms to the fax number below.

Physicians or Healthcare Facilities/Organizations

Physicians, healthcare facilities and organizations may request medical records by contacting the Health Information Management Department at the below phone number. Phone calls are returned within one business day.