Westfields Hospital

  • About Westfields
  • Directions
  • Contact Us
  • Make a Gift
  • Hospital & Clinics
    • Hospital Care
    • Primary Care
    • Specialty Clinics
    • Walk-In Clinic
  • Find a Doctor
    • Search Our Doctors
  • Patients & Guests
    • Billing and Payments
    • Patient Financial Services
    • Disclosure of Health Info
    • Guide to Patient Services
    • Patient Rights and Services
    • Pharmacy
    • Privacy Practices
    • Visiting Hours
    • Transportation Van
  • Health & Wellness Programs
    • Classes
    • Support Groups
    • Programs
  • Home
  • Hospital & Clinics
  • Find a Doctor
  • Patients & Guests
  • Health & Wellness Programs
  • Directions
  • Make a Gift
  • Contact Us

Patients & Guests

  • Billing and Payments
  • Food Service
  • Gift Shop
  • Patient Financial Services
  • Disclosure of Health Info
  • Guide to Patient Services
  • Patient Rights and Services
  • Pharmacy
  • Transportation Van
  • Privacy Practices
  • Visiting Hours

Disclosure of Health Info

Home > Patients & Guests > Disclosure of Health Info

Disclosure of Health Info

Click to view the Patient Authorization for Release of Protected Information form

Click to view Permission to Verbally Discuss Protected health Information with Family and Friends form

Completed forms can be faxed to 715-243-3414.

©2018 Westfields Hospital
  • HealthPartner Apps
  • Newsletter
  • Community Health
    Improvement Plan
  • Quality, Safety & Service
  • virtuwell
  • Contact Us
  • Legal
  • Careers
  • Privacy
  • Volunteer
  • Medical Staff
    Services
  •  
  • Nondiscrimination notice
  • Facebook

Language assistance:
Español ພາສາລາວ Oromiffa हिंदी ภาษาไทย Adamawa Hmoob Deutsch አማርኛ Shqip ελληνικά 日本語 Tiếng Việt العربية unD Srpsko-hrvatski Diné Bizaad नेपाली 繁體中文 Français ខ្មែរ ગુજરાતી Ikirundi Ukranian Pусский 한국어 Deitsch اردو Kiswahili Af Soomaali Tagalog Polski Italiano Norsk