How to request access?

  1. Complete the Request to release and disclose patient information form
  2. The completed form can be sent by:
    1. Fax:  952-835-4403 OR
    2. Mail:   EPPA
            ATTN:  Health Information Management/ROI
                4300 MarketPointe Drive, Suite 100
               Bloomington, MN 55435

You can also download the form here:

Request to Release and Disclose Patient Information


Call: 952-857-1557

Available Monday through Friday from 8AM to 4:30PM