The Health Information Management Services department at Washakie Medical Center is responsible for keeping complete medical records for each patient.
Hours of Operation:
7:30 am -4:30 pm
Monday - Friday
Obtaining a copy of your Medical Record:
Your original medical record is property of Banner Health, but the information in it belongs to you.
To obtain copies of your medical record information, please print the release form provided below.
- English Release of Information Authorization
- En español "Permiso Para Copiar Documentos Médicos," en español"
You may present this completed form:
- In person in the Medical Records department
- By mailing to Medical Records, Washakie Medical Center, PO Box 700, Worland, WY 82401
- By faxing to Medical Records at (307) 347-6996
- $15 for the first 15 pages
- $.50 per page after 15 pages
- For records on microfiche-$10 base fee plus $1.50 per page
In order to fulfill your request in a timely manner, please ensure this form is signed and complete before submitting. A photo ID is required to be shown when picking up your copy of your medical record. You may also request your medical record to be copied onto a CD for your convenience.
Questions or Concerns;
To assist with your requests or address your concerns, our health information staff is available to help at (307) 347-3221ext 167.
Washakiie Medical Center is committed to comply with the Health Insurance Portability and Accountability Act (HIPAA), Security, and Electronic Transaction Standards. For any HIPAA or privacy concerns, please contact our Washakie Medical Center privacy officer at (307) 347-3221 ext. 167 or email.