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Patients & Visitors Medical Record Request

Medical Record Request

SSM Health St. Clare Hospital - Baraboo is committed to protecting your privacy and confidentiality. The Health Information Management Department maintains SSM Health St. Clare’s patient health care records. We also review all requests for copies before processing. 

How to Obtain a Copy of a Birth Certificate

In order to obtain a copy of a birth certificate, and the individual was born in Wisconsin, you may request a copy from the State of Wisconsin Department of Health, Office of Vital Records. SSM Health St. Clare does not have copies of birth certificates. 

How to Obtain Copies of Medical Records

In order to obtain copies of your medical records, you are required to fill out an “Authorization for Use and Disclosure of Protected Health Information” form. 

You may request one by calling the Health Information Management Department at 608-356-1441 or download the PDF file below. 

Note: A separate authorization is required for each request. 

We require patient or legal guardian authorization in order to release copies of your medical records. These records are sent by mail and are not available by facsimile. The original records are kept at SSM Health St. Clare. You may request copies of your records at any time. ​​

Copy Fees

For current information about copy fees, please contact the Health Information Management Department at 608-356-1441. Please expect a turnaround time of 10-14 business days for your request to be processed. 

For more information, please contact the Health Information Management Department at SSM Health St. Clare Hospital - Baraboo at 608-356-1441.​