To request the release of your private health records, please download and fill out one of the authorization forms below. Then, call the site where you received treatment to ask how you should submit the form. For contact information, see the list below.
Authorization Forms
You may call the phone numbers below for help submitting your form. Please note: Staff at these numbers will not share your information verbally.
Fairview Clinics (see clinic list)
Health Information Management
4000 Central Ave.
Columbia Heights, MN 55421
Phone: 763-852-8850
Fax 612-365-0304
Fairview Lakes Medical Center
Health Information Management
5200 Fairview Blvd., Wyoming, MN 55092
Phone: 651-982-7870; Fax: 651-982-7122
Fairview Northland Medical Center
Health Information Management
911 Northland Dr., Princeton, MN 55371
Phone: 763-389-6573; Fax: 763-389-6545
Fairview Ridges Hospital
Health Information Management
201 East Nicollet Blvd., Burnsville, MN 55337
Phone: 952-892-2060; Fax: 952-892-2024
Fairview Southdale Hospital
Release of Information, LL25
6401 France Ave. S., Edina, MN 55435-2199
Phone: 952-924-1414; Fax: 952-924-8443
University of Minnesota Health Maple Grove Clinics
Health Information Management
14500 99th Avenue North Maple Grove, MN 55369
Phone: 763-898-1000; Fax 763-898-1009
Fairview Range
Call the site (See list of clinics)
University of Minnesota Medical Center
University of Minnesota Masonic Children's Hospital
West Bank campus
Health Information Management office: 612-273-4370
Release of Information Contact:
2450 Riverside Ave., Minneapolis, MN 55454
Phone: 612-273-4359; Fax: 612-273-4069
East Bank campus
Health Information Management office: 612-626-3535
Release of Information Contact:
420 Delaware Street SE, MMC 601, Minneapolis, MN 55455
Phone: 612-626-3238; Fax: 612-273-2345
