To request a copy of your medical records, you must print and fill out the QuadMed Authorization to Release Protected Health Information (PHI) form (see below).

Once you have completed this form, you can:

• Fax: Fax your completed form to 414.622.3809.
• Email: Email your completed form to medicalrecords@quadmedical.com.
• Personally deliver: QuadMed Authorization to Release forms are accepted during normal business hours at your local health and wellness center. Please bring a photo ID when you are dropping off this form.
• Mail: Please send your completed form to:
  Health Information Management – Release of Information
  N64W23110 Main Street
  Sussex, WI 53089

Requests are usually completed within 7-10 business days, but may be delayed if your medical records are not available or complete. We will make every effort to complete time-sensitive requests promptly. You will be notified in the event of a delay.

QuadMed has partnered with Sharecare to process medical record requests. For questions regarding the status of your medical record, please contact Sharecare at:

• https://recordstatus.sharecare.com
• Phone: 800-560-3800, option 2