Ellsworth Municipal Hospital

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Release of Information

Here is a Release of Information Form that you can use to obtain records from Hansen Family Hospital.

Request for Release of Health Information

Please note that if you are obtaining your medical records for personal use, there will be an associated fee.

Return or mail completed Release of Information form to:

Hansen Family Hospital
ATTN:  Health Records
920 South Oak Street
Iowa Falls, IA 50126-2400

Call Health Records at HFH, 641-648-7057, if you have any questions regarding the Release of Information Form for your HFH Medical Records.

For questions on releasing your clinic records to another provider, please contact the Health Records staff at your clinic.

©  2014 

Hansen Family Hospital | 920 South Oak Street | Iowa Falls, Iowa 50126 | 641-648-4631

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