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.