Health & Human Services – Administrative

Release of Information

Medical records may be requested at any time. To request medical records, please fill out the release of information form. The form is available at our office or you can download the form on our website. If you wish to receive a copy of your medical records for your own use, you may be charged a fee for processing the request. There is no fee for transferring your medical records directly to another healthcare provider. Please note that medical records request may take several days to process.

Please refer to the downloads for information on copying charges for records.

Drop off or mail your request to:
Green Lake County DHHS
Attn: Medical Records
571 Cty Rd A
Green Lake WI 54941

Fax the release to:
Attn: Medical Records

Email the release to:

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Work Permits

Work permits can be obtained at the Department of Health and Human Services. Work permits are required for children ages 13-15 years old. The youth must be present to sign paperwork. An appointment is not necessary. Each work permit will also receive a copy of the child labor laws.

What is needed?

  • Proof of age (one of the following)
    • Birth Certificate
    • Driver’s License
    • Baptismal Certificate
    • Passport as a last resort
  • Copy of social security card
  • Letter from employer stating what the youth will be doing at place of employment
  • Letter/signature from parent/guardian giving minor permission to work at place of employment
  • $10 payment (cash, check, or money order)

For further information about the state child labor laws, call the Equal Rights Division in Madison 608-266-6860 or Milwaukee 414-227-4384.

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Contact Us

  • Office Hours:
    8:00am – 4:30pm
  • Address:
    571 County Road A
  • Green Lake, WI 54941
  • Phone: 920-294-4070 or 800-664-3588
  • Fax: 920-294-4139
  • Contact Us: Email