Instructions for Obtaining Medical Records from WI Department of Corrections
When a requester knows an individual is no longer incarcerated and is seeking DOC Medical Records, the requester should contact Dodge Correctional Institution - Central Medical Records (see 3 below). For a request pertaining to an individual who is currently incarcerated, the requestor should contact the facility where the individual is currently located, or utilize the email inbox in step 2 below.
For a link to the current version of the DOC-1163A Authorization for Use and Disclosure of Protected Health Information - PHI, the requestor can choose to download the English or Spanish version:
This form needs to be signed by either the subject of the request or a person authorized to consent to disclosure.
Process
When a requester is uncertain of where the individual is currently located, they may navigate via the following link to the Public DOC offender locator and then proceed to steps (2) or (3) below accordingly: https://appsdoc.wi.gov/lop/welcome
When a requester knows the DOC facility in which the individual resides, complete the DOC-1163A, and list “WI DOC” as the Individual/Agency Being Authorized to Disclose PHI. Requesters may email the completed DOC-1163A to DOCMedicalRecordsActive@wisconsin.gov.
When a requester knows the individual is released from DOC and no longer incarcerated, complete the DOC-1163A, and list “WI DOC” as the Individual/Agency Being Authorized to Disclose PHI. Requesters may mail/fax/email the completed DOC-1163A to Dodge Correctional Institution – Central Medical Records using the below contact information:
ADDRESS:
Dodge Correctional Institution – Central Medical Records
PO Box 661
1 W. Lincoln Street
Waupun, WI 53963
FAX: 920 324-6369
EMAIL: DOCDAIDCICentralMedicalRecords@wisconsin.gov
PHONE: 920 324-6296