Program Directory
OCD and Anxiety
Autism and Anxiety and Mood Disorders
Eating Disorders
Depression and other Mood Disorders
Addiction
Trauma Recovery (PTSD)
Emotional Dysregulation
Why Choose Rogers
In this time of crisis, Rogers Connect Care is here for you. Learn more about our evidence-based treatment in a secure virtual environment. >
As a patient, you have the right to get a copy of your medical record. Please follow these simple steps to request a copy of your medical record free of charge.
Step 1: Complete an authorization in writing for Rogers to release your information.
Please print and complete the form.
English form
Spanish form
Instructions for Completing Authorization to Release Protected Health Information
Spanish Instructions for Completing Authorization to Release Protected Health Information
*Please note, due to state and federal laws, we are unable to process incomplete forms.
Step 2: Submit your request to the Release of Information Team at Rogers.
By mail:
Rogers Behavioral Health Health Information 34700 Valley Road Oconomowoc WI 53066
By fax: 262-646-5745
By Email: releaseofinformation@rogersbh.org
Your request will be completed within five to seven business days from the date it is received.
For questions, please call or email the Release of Information Team: Phone: 800-767-4411, Option 3 Email: releaseofinformation@rogersbh.org
HIPAA Notice of Privacy Practices
Revocation of Authorization to Release Information
Real people sharing what they have overcome and how Rogers helped through their process.
Christopher discusses his experience with ... Read More