Request Medical Records


We want to make it as easy as possible for you to request copies of your medical records.

Wisconsin Spine and Pain (WSP) takes your medical records seriously at our facilities. We know your privacy is extremely important, and we take all the necessary steps to make sure your documents are secure. Dedicated, experienced personnel who understand and observe all the latest rules for safeguarding medical records oversee our record-keeping system. 

We respond to requests for medical records sent through the proper channels.

To request your records and get the quickest results is to download the Release of Information Authorization forms in the links below.

For the following patient information request scenarios: 

  1. Request information from WSP to another facility [CLICK HERE] 

  2. Request information from another facility to WSP [CLICK HERE]

  3. Request information from Advanced Pain Management to WSP [CLICK HERE] 

Once completed, you can return the authorization to a Wisconsin Spine and Pain office or you can fax it to our medical records department directly at: 

FAX Number: 888-720-0495

If you are having difficulty downloading or don’t have a printer you can call us at medical records department at 920‐204‐6758 and we will mail or fax the Release of Information Authorization to you.

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