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Manage Your Medical Information

Use the consent forms on this page to request release of protected medical information (e.g., medical records, immunization records, clinical history) for yourself and/or any OMC patient for whom you are legally responsible. 

Authorizations for the release, use, and disclosure of patients' Protected Health Information

Please fax completed consent forms to OMC's Health Information Management department at 507.287.2777.

Consent - Authorization for Allowing Verbal Communication of Patient Health Information (English)

Consent - Authorization for Allowing Verbal Communication of Patient Health Information (Spanish)

Consent - Authorization for Allowing Verbal Communication of Patient Health Information (Somali)

Consent - Authorization for Release of Health Information (English)

Consent - Authorization for Release of Health Information (Spanish)

Consent - Authorization for Release of Health Information (Somali)

Consent - Authorization for Use and Disclosure of Patient Health Information for Publicity Purposes (English)

Questions? Concerns? Contact OMC's Health Information Management department Monday-Friday, 8:00 AM – 4:30 PM, at 507.287.2752 or use our Contact Us form.

Contact Us

OMC Health Information Management can be reached Monday through Friday, 8:00 AM to 4:30 PM (except on holidays), at:

tel: 507.287.2752 

fax: 507.287.2777

Mailing address:

Olmsted Medical Center
Attn: Health Information Management
PO Box 4300
Rochester, MN 55903-4300