How to Request Medical Records – Patient

We have two options for you to request your medical records. The most efficient way is to request online, however you can also download and return a form.

Patient Request Online

Our online records request verifies your identity by asking for a photo of your driver’s license or state ID, which you can take via webcam or smartphone. It takes approximately 5-10 minutes, and you choose either electronic or mail delivery! Click: Request Your Medical Records Online.

OR – Patient Request By Mail or In Person

Please download and complete this form: Authorization to Disclose Health Information. Print clearly and fill out as much information as possible. If you are unsure of specific dates, please give a range of dates or specific information you are looking for to help us find the correct medical information. Sign and date the form in the designated area on the bottom of the form. Based on the type of request you make, there may be a charge for this service. Please allow 7 – 10 days for processing.

You may return the completed form in person, by fax to 320.634.2262 or by mail:

Glacial Ridge Hospital
Attn: Release of Information
10 4th Ave. SE
Glenwood, MN 56334

How can I get a copy of a birth certificate?

All birth certificates for those born at Glacial Ridge Hospital in Glenwood, MN, may be obtained from the Minnesota Department of Health (MDH) or the Recorder’s Office at the Pope County Courthouse.

Questions

If you have questions regarding the release of information, please call 320.634.4521.

How to Request Medical Records – Healthcare Privider

This link is for healthcare providers only. Must have HIPAA-compliant organization email address. Click: Request a Patient’s Medical Record Online.