English
Medical Records
The mission of the Health Information Management (HIM) Department at Rogers Behavioral Health is to ensure complete and accurate medical records and timely access to information while protecting patient confidentiality.
Rogers Behavioral Health requires written authorization to release records to you or your designated representation.
Questions? Contact the Release of Information Team at 833-984-3366. Office hours Monday-Friday, 8 am to 4:30 pm CT.
Request your Medical Records
You have the right to your medical record. Processing time varies up to 5-7 business days after your written request has been received. Notification will occur if additional information is needed to process your request.
Rogers Behavioral Health does not charge for copies of records at this time.
Submit your request to the Release of Information Team at Rogers Behavioral Health.
Mail:
Rogers Behavioral Health
Health Information
34700 Valley Road
Oconomowoc WI 53066
Fax: 262-646-5745
Email: releaseofinformation@rogersbh.org
Authorization Forms
Download and complete the Rogers Behavioral Health Authorization form. Instructions are included in the PDF.
- Authorization Form (PDF) English
- Authorization Form (PDF) Spanish
- Visual Management Sample Authorization
HIPAA
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Request Portal Access
Rogers Behavioral Health Portal is now available. Call Health Information Management at 833-984-3366 to enroll.
Download the HealtheLife app:
Revocation of Authorization
Revocation of previous Authorization needs to be in writing.
Note: Revocation occurs when Health Information Management receives the completed revocation form. Please contact the Release of Information Team for more details.
FAQ
Do I need an authorization for each outpatient provider if they are located at the same facility?
No. One authorization can be completed as long as the facility is listed. Additionally, list the providers for the facility.
How do I obtain a Date of Service Letter?
You can obtain a Date of Service letter through Health Information Management. Authorization should be completed with the Date of Service option (in section 3) and sent to the Health Information Department.
What is the difference between Entire Medical Record and Abstract?
Entire medical record is a complete record of your treatment at Rogers Behavioral Health.
Abstract is a summary of your treatment at Rogers Behavioral Health which includes the following: Psychiatric Evaluation, Discharge Summary, Consultation/History & Physical and Medications.
Chart Amendment Request
If you believe there is incorrect information in the medical record, please complete this form. Completed forms should be forwarded to releaseofinformation@rogersbh.org. Your request will be put in the system for processing and you will be contacted regarding your requested changes.