Cures Act

Our electronic medical record request form is for outside clinicians and professionals to make requests to access the Bellin Health Electronic Medical Record System. Your submission will be sent to our Interoperability Team for review and responded to within 30 days.

If you are requesting individual medical records release, please use MyChart or call Bellin's Health Information Management at (920) 433-3557.

Request Emplify Health Epic link here and click Request New Account.