Release of Information (Medical Records)

The Release of Information Department maintains all medical records related to the care you have received at the Mankato Clinic. Access to medical records is protected by federal HIPAA regulations.

Copies of medical records may be released upon receipt of an Authorization to Release and Disclose Patient Information form completed by the patient (if over 18 years of age) or parent/legal guardian. The authorization form must be completed in its entirety or we will be unable to release your records. 

NOTE:  If you are in need of immunization records, a signed authorization form is not required.  Please contact the Release of Information Department at the numbers listed below and they will be able to help you.

You may obtain the form by utilizing one the following methods:

  • Below you can access and print the authorization form.  
  • Request a form from the Release of Information Department by calling 507-389-8633, 507-385-4037, or 507-385-3959.
  • Stop at any Release of Information office:
    • Mankato Clinic Main Street, 1230 East Main Street, Mankato, MN
    • Mankato Clinic Children’s Health Center, Wickersham Campus, 1421 Premier Drive, Mankato, MN
    • Mankato Clinic North Mankato, 1575 Lookout Drive, North Mankato,MN
  • Typed signatures are not valid on authorization forms.

The completed form can be dropped off at any Mankato Clinic location, mailed to either address provided on the form, faxed to 507-388-1878, 507-625-8980, or 507-345-4130 or emailed to: ROI@mankatoclinic.com  Please fax all legal requests to 507-388-1878.

The Release of Information Department is available from 8:00 am- 5:00 pm, Monday through Friday.

Release of Information Authorization Form