Sleepy Eye Medical Center’s Health Information Management Department maintains and protects patients’ health records.
If you’ve been receiving care outside of Sleepy Eye Medical Center, you’ll need to complete an authorization form. This form allows outside facilities to share your medical record with us. Documentation of any previous health conditions and treatments will help our providers appropriately care for your health care needs.
You’ll need to complete this form if you plan to receive care outside of Sleepy Eye Medical Center as well.
If you send your spouse, family member, friend or significant other to pick up copies of your health information, you will need to indicate written permission for that individual on the form prior to their picking up this information.
Please note that if you’re requesting your medical records for personal use, you may be charged a fee.
Download an Authorization Form
Please print, complete, sign and return the form in one of the following ways:
- Fax the form to 507-794-5950.
- Mail the form to: Sleepy Eye Medical Center
Attn: Health Information Management
400 4th Ave. NW
Sleepy Eye, MN 56085 - Physically drop off your form by stopping by the Clinic Reception Desk and asking for a member of the Health Information Management (HIM) team.