The Health Information Management Department of Door County Medical Center is happy to assist patients in arranging for a copy of their health records to be sent to insurance companies, Workers Compensation carriers, disability agencies, attorneys, etc. Federal and state law requires a more detailed authorization for this type of disclosure. To request a copy of your health information/records to be sent to a third party, please download, print, and complete the form at the bottom of this page and mail, fax or email it to: Health Information Management Department Door County Medical Center 323 South 18th Avenue Sturgeon Bay, WI 54235 Fax: 920.746.3694 Email: DCMC_HIMRESPONSE@dcmedical.org There may be a charge for these copies. DCMC-Main-Autho-Form