Release of Information

In order for DCH to process your request for the release of your medical records, you must complete a form called the Authorization to Release Protected Health Information. We cannot process an incomplete form, so it is important that you complete each section. Please remember to sign and date the release form and fax to 320-762-6127 or mail it to:

Douglas County Hospital
Attention: Release of Information
111-17th Avenue East
Alexandria, MN 56308

Download Release of Information Form

If you have general questions on the authorization process, please email us at roi@dchospital.com or call (320)762-6081. Please do not add personal information through email (birthdate, dates of service, diagnosis, or procedures).

Frequently asked questions

Is there a charge for a copy of my medical record?
A patient’s first request for one year of medical records for their own personal request is free. There may be a charge for other types of requests. Call (320)762-6086 for an estimate of charges upon receipt of authorization.

How long will it take to get a copy of my medical record?
We usually process requests within five business days.

How can I obtain copies of my children’s medical records?
Under most circumstances, a parent can authorize release and get copies of medical records for a child who is under age 18. The parent must complete and submit an Authorization to Release Protected Health Information.

Can I obtain copies of my spouse’s medical record?
You can only obtain a copy with the patient’s signed authorization.

How do I obtain a copy of my birth certificate?
We don’t have copies of birth certificates for babies born at DCH. In Minnesota you can call any County Recorder’s Office Vital Records Division in the state of Minnesota to obtain a copy of the birth certificate or contact the Minnesota Department of Health at www.health.state.mn.us.