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Medical Records Request

Please print and complete an attached form (below) and mail it to:

Wesley Medical Center
Health Information Management
Release of Information
550 North Hillside
Wichita, Kansas 67214

The Health Insurance Portability and Accountability Act (HIPAA) requires that all portions of the attached form be completed. The form is to be signed and dated by the patient or legal representative. Please call 316 962-2513 if you have questions.

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