An Authorization for Disclosure form is required when you request copies of your medical/consumer records be sent to another healthcare provider or third party.
Mail, fax, email, or hand-deliver form to:
Walworth County Department of Health and Human Services
1910 County Road NN
P.O. Box 1005
Elkhorn, WI 53121
Phone: 262-741-3200, Fax: 262-741-3217
Email Health and Human Services
For assistance obtaining records, call 262-741-3200 between 8 a.m. and 4:30 p.m. and ask for Medical Records.
Notice of Privacy Practice
Review the Walworth County Health and Human Services’ Notice of Privacy Practice (PDF) and the Spanish version (PDF).