Patient Information

NOTE: The links will open in a new window.  You will see a tab on the right side of the screen to “Open PDF.”  Once it is opened, in the right column, you will see a menu.  Click “Fill & Sign.” Place the cursor on the first line and it will allow you to start typing your information.  Continue the same throughout the document.  When finished, save the document to you computer.  Proceed to print the document, and either fax or send to address indicated below.

To request information from Compass Health Network:

Important Steps:

⦁ Determine what type of records you need to request. (Behavioral Health, Dental, Primary Care)
⦁ Complete all fields on the authorization form(s) when requesting the release of your records.
⦁ After the form(s) is signed and dated; deliver, fax or mail the information to an office listed below.

Behavioral Health
Request My Records: Access to Protected Health Information (PHI): English | en Español
Send My Records: Authorizations for Disclosure: English | en Español

Primary Care and Dental
Request My Records: Access to Protected Health Information (PHI): English | en Español
Send My Records: Authorizations for Disclosure: English | en Español 

To request information from other facilities:
To give Compass Health Network access to outside medical records, you will need to authorize release from your current/previous medical provider(s). Please complete the form and deliver, fax or mail to an address indicated below.

Authorization for the Release of Medical Information From Other Behavioral Healthcare Facilities:  English | en Español

Authorization for the Release of Medical Information From Other Medical/Dental Healthcare Facilities:  English | en Español

If there is information in Compass Health Network’s medical record about you that you believe is inaccurate or incomplete, you have the right to request the information be changed. Please complete the form and send it to the fax or address indicated below.

Request for Amendment of Personal Health Information: English | en Español

For questions regarding the above forms, please contact your local Health Information Management Office (Medical Records):

Compass Health Network – HIM Clinton
1800 Community Drive
Clinton, Mo.  64735
PH: 660-890-8116
FAX: 660-890-8116
himclinton@compasshn.org

Compass Health Network – HIM Wentzville
1032 Crosswinds Court
Wentzville, Mo.  63385
PH: 636-332-2104
FAX: 636-489-0651
himwentzville@compasshn.org

HIM ROYAL OAKS HOSPITAL – Attn: HIM
307 N. Main
Windsor, Mo.  65360
PH: 660-647-2182
FAX: 660-647-2034
himroh@compasshn.org

Compass FHC – HIM Department
1001 W Worley
Columbia, MO 65203
PH: 573-214-2314
FAX: 573-814-2835

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