Medical Records Request

Email info@pauquette.com For information on how to obtain records.

Fax records or requests to 608-268-9780.

Mail records or request to:

Pauquette Center – ATTN: JoEllen Westendorf, 1002 Lincoln Ave., Baraboo, WI 53913

Use when requesting access to client's PHI as self or guardian.

BLANK - HIPAA Request for Access to Health Information

Use when wanting another entity to have access to client's PHI.

BLANK Authorization to Use and_or Release Protected Health Information - BLANK