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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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