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Health Release Info

If you would like to request copies of your medical records please download the file below and fill it out completely.  You can then fax or mail the completed form and someone from our HIM Department will contact you.

Fax Number:  (620) 723-2195

Mail Form:      Kiowa County Memorial Hospital
                       Attn:  HIM Dept. Release Of Information
                       721 W. Kansas
                       Greensburg, KS  67054