Medical Records / Health Information Department (HIM)
Your medical records are important to us. HIM protects privacy and maintains all medical information created by the services provided at Southeast Colorado Hospital District. The HIM staff strive to provide quality service to patients who request their medical information.
Medical Record Authorization Form
The authorization form can be printed off. Areas marked must be completed by the patient unless the patient is a minor, then the parent or legal guardian must complete these areas. Signature and date are required. The form can be returned to the Health Information Department in person, by mail or by fax.
For more information contact:
Health Information Management Director
373 E 10th Ave. Springfield, CO 81073
Office (719) 523-2125
Fax (719) 523-4290