Phone: (563) 252-1121
Fax: (563) 252-5547
Monday – Friday
8 a.m. – 4:30 p.m.
Medical Record Authorization Form
Release of Information to Family/Friends Form
MyChart is a secure patient website that allows you to conveniently manage your personal health online and have access to your medical records. Because MyChart is web-based, you can log in at any time, any place. Get started with MyChart.
HEALTH INFORMATION SERVICES
The scope of services provided by Health Information Services is based upon a collaboration and information-sharing format to enhance patient care. Health Information Services are provided to all areas of the facility, as appropriate for needs and security levels. Health Information Services include the provision of providing an accurate patient record with emphasis on the following:
- Record Processing
- Record abstracting, analysis and coding
- Transcription of dictation for the medical record
- Record retrieval, filing and limited storage
- Release of records
The scope of services also encompasses efforts made to provide:
- Timely and easier access to complete information throughout the organization
- Improved data accuracy
- Demonstrated balance of proper levels of security vs. ease of access
- Use of aggregate data, available through computerized reporting in Health Information Services, to assist all healthcare providers with information that allows for identification of opportunities to improve performance.
- Accessibility of the medical record at all times to those authorized persons requesting their use for patient care.
REQUEST MEDICAL RECORDS
For record requests or release of information questions, please call (563) 252-1121. A completed Medical Record Authorization Form must be sent via mail or fax it to (563) 252-5547 or email to HIMusers@guttenberghospital.org
To transfer medical records from one provider to another, give your new physician’s office the following information so we can transfer records.
- Name of your previous physician
- Their fax number
- Their phone number
You may be requested to complete an authorization for release of protected health information form, prior to the information being released.
REQUEST BIRTH CERTIFICATES
For questions or to get a copy or your birth certificate, please contact the county or state offices:
Clayton County Court House
111 High St NE
Elkader, IA 52043-0278
Iowa Department of Public Health
Attention: Vital Records,
Birth Registration Program
Lucas State Office Building, 1st
Des Moines, IA 50309-0075