Patient Accounts & Billing: Release of Information

 

Release of Information

If you need medical record information for care you received at Park Nicollet sent to a non-Park Nicollet provider, please complete the Patient Authorization for Release of Protected Health Information (PDF).

If you need medical record information for care you received at a non-Park Nicollet provider sent to Park Nicollet, please complete the Patient Authorization for Release of Protected Health Information (PDF).

If you have questions or need assistance, refer to the information sheet or call Health Information Management at 952-993-7600. If you have questions regarding radiology images, call 952-993-5427.

Permission to Discuss Protected Health Information

At Park Nicollet, we understand the importance of privacy when it comes to your health information – that's why we don't discuss your medical care with anyone that you haven't specifically authorized. If you'd like certain friend, family members or others to be involved in your care, please complete the Permission to Verbally Discuss Protected Health Information with Friends and Family (PDF). This will let us know who you would like us to talk to regarding appointment information, lab and test results, treatment information and other medical information that you authorize.

Birth Certificates

To request a certified copy of a birth certificate, visit the Hennepin County Service website.