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Health Information

Please find a release of Information Form available online. If you are looking for a form that is not listed below, please call Southwest Health at (608) 348-2331 for further assistance.

  • Click here to print an Authorization to Disclose Protected Health Information Form
  • There are multiple ways to submit your completed form. You can either:
    • Submit your form by faxing it to 608.342.5011
    • Mail your form to Southwest Health at 1400 Eastside Road, Platteville, WI 53818
    • Drop off your form at Southwest Health’s Front Desk of the ER, 1st or 2nd Entrance.

Do you have any additional questions? Contact Health Information Management at (608) 342 – 4718, option 2.

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