Medical Records Request
To request your medical records released from Midwest Medical Center
Please mail or fax the completed authorization to:
Midwest Medical Center
Attn: HIM Department
1 Medical Center Drive
Galena, IL 61036
Fax: 815-777-2671
To request your medical records be released to Midwest Medical Center
Please mail or fax the completed authorization to:
Midwest Health Clinic
Attn: Midwest Health Clinic/Provider Name (if known)
1 Medical Center Drive
Galena, IL 61036
Fax: 815-776-7385
Release of Information Forms
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Release of Information Form - To Facility
Release of Information Form - To Facility -
Release of Information Form - From Facility
Release of Information Form - From Facility -
Release of Information Form - Workman's Comp
Release of Information Form - Workman's Comp
