Medical Records

Gundersen Health System respects each patient's right to confidentiality and privacy of healthcare information. We make every attempt to protect the privacy of patient information so it is not heard, read or shared with others for any reason other than to promote the best healthcare for our patients.

In order to disclose protected health information, we require signed authorization from the patient or legal guardian. The healthcare record is the property of Gundersen and is maintained for the use of the Hospital, Clinic, Medical Staff and for the benefit of the patient. You may request copies of your health information at any time.

How to obtain copies of your medical records

You have the right to view and/or request copies of your health care record. To view your healthcare record, you must make an appointment at (608) 775-3199. Photo identification is required.

In order to obtain copies of your medical records, please download and complete the Authorization for the Disclosure of Protected Health Information form and send it to:

Gundersen Health System
Medical Records
1900 South Avenue, AVS-001
La Crosse, WI 54601

Authorizations may also be faxed to (608) 775-4706.

Turnaround time: It takes approximately 3-5 days to complete a request once it has been received. We realize there are circumstances when your medical record will require immediate disclosure. If this is your situation, please call (608) 775-3199.

Copy fees: There is no charge for copies of your healthcare records if they are mailed directly to another provider or healthcare facility. In other cases, there may be a copying charge. For specific fees, please contact (608) 775-3199.

To obtain a copy of a birth certificate, if the individual was born in La Crosse County, you must request a copy from your County Register of Deeds (see La Crosse County Register of Deeds). Gundersen Health System does not have copies of birth certificates. You may also call (608) 785-9644 for additional information.

Picking up healthcare records

If you plan to pick up copies of your medical records, you must provide photo identification for verification purposes. If someone else is picking up your medical records for you, please send a note giving Gundersen permission to provide your medical records to that person.

Others' medical records

If you are requesting records on someone other than yourself, you will need to provide legal documentation verifying legal guardianship, power of attorney, personal representative, etc. Biological parents may request copies of their minor child's records as long as their parental rights have not been terminated.

Right to amend your protected health information

If you believe information within your medical records is incorrect or incomplete, you may request to have that information corrected. You have the right to request an amendment for as long as the information is kept by or for Gundersen. Requests to make a correction to your records must be in writing. Please complete the Request to Amend Protected Health Information form and send to:

Gundersen Health System
HIM Coordinator
1900 South Avenue, AVS-001
La Crosse, WI 54601

In certain cases, we may deny your request for an amendment if information:

  • was not created by us, if the person or entity that created the information is not available to make the amendment
  • is not part of the health information kept for Gundersen Health System
  • is not part of the information you would be permitted to inspect and copy
  • is accurate and complete

Restrictions on health information

You have the right to request restrictions on disclosures of your medical information. We are not required to comply with your requested restriction. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment, to comply with the law or otherwise specified on the request form.

To make a request for restrictions, please print and complete a Request to Restrict Access to Protected Health Information form. Please send completed form to:

Gundersen Health System
Patient Information Coordinator
1900 South Avenue, FBB-001
La Crosse, WI 54601

Authorization for verbal communication

Patients have an opportunity to authorize Gundersen to contact a patient at home and leave detailed messages on their answering machine or with someone they may have authorized us to share their health information with. If you are requesting to have this form on file, please complete the Authorization for Verbal Communication of Health Information form and send to:

Gundersen Health System
Medical Records
1900 South Avenue, AVS-001
La Crosse, WI 54601

Revocation of an authorization

You may revoke an authorization, in writing, at any time. We are unable to take back disclosures we have previously made with your authorization. If you wish to revoke a previously signed authorization, please complete the Revocation of Authorization form and send to:

Gundersen Health System
Medical Records
1900 South Avenue, AVS-001
La Crosse, WI 54601

Right to receive an accounting of disclosures

You have a right to request an accounting of disclosures. This is a list of those people with whom Gundersen may have shared your health information, with the exception of information shared for purposes of treatment, payment or healthcare operations or when you have provided us with an authorization to do so. We will provide the list at no cost once during each 12-month period. For additional requests, we may charge you a fee. We will notify you of the fee and you may choose to withdraw or modify your request at that time. To request an accounting of disclosures, please complete the Accounting of Disclosures form and send to:

Gundersen Health System
Medical Records
1900 South Avenue, AVS-001
La Crosse, WI 54601

Love + Medicine

Every day, Gundersen Health System delivers great medicine plus a little something extra—we call it Love + Medicine.

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