An authorization form is required when:
Fees
Steps
1. Print and fill out the appropriate Release of Information Authorization Form:
2. Sign the form.
3. Mail or Fax the form to:
For Human Services, Child Protective Services, Adult Protective Services, Public Health, and Outpatient Mental Health/AODA Records:
Human Services Center
Attn: Centralized Records
514 Riverview Avenue
Waukesha, Wisconsin 53188
(262) 548-7212
Fax: (262) 548-7274
Email
For Mental Health Inpatient, Day Treatment or Community Support Health Information:
Mental Health Center
Attn: Health Information
1501 Airport Road
Waukesha, Wisconsin 53188
(262) 548-7950
Fax: (262) 896-8046
Email
Pick Up
A photo ID will be required if you pick up your own records. If you name someone else to pick up you records, please make him or her aware they will need to show their own photo ID.
Read our Notice of Privacy Practices Regarding Health Information (6243-B, Rev. 5/1/2023)
Lea nuestro Notificación de las Normas de Privacidad Acerca de la Información de Salud (6243-B, Rev. 5/1/2023)
Acknowledgement of Receipt of Notice of Privacy Practices Regarding Health Information (6243-A, Rev. 1/25/2022)
Acuse de Recibo de Aviso de Prácticas de Privacidad Acerca de la Información de Salud (6243-A, Rev. 1/25/2022)
Convenient, easy acess to your Waukesha County healthcare information. Stay connected on your path to wellness and recovery.