To make an in-person request for medical records or to pick them up, please visit the Cheyenne Regional Medical Center West Campus (main hospital), located at 214 East 23rd Street.
Medical records are available Monday-Friday, 8 a.m. to 4:30 p.m.
For questions related to medical records, please call (307) 633-7925, option 1.
Submitting completed forms
After downloading and completing any of the forms below, you can submit them via mail, fax or email to:
Cheyenne Regional Medical Center
214 East 23rd Street
Cheyenne, WY 82001
Fax: (307) 432-3108
To submit a completed form via email, click here.
Authorization for release of health information
If you would like to receive a copy of your medical records or have medical records sent to another party, please download and complete an authorization for release of information form.
If you want a copy of your medical records for yourself, much of your medical information can be found immediately in your MyChart account. (To access MyChart, click here.)
Authorization to verbally disclose health information to family or other
To grant family members or others the ability to speak to CRMC personnel or Cheyenne Regional Medical Group (CRMG) clinics about your medical information, upcoming appointments, or billing, please complete and submit the verbal disclosure authorization form.
Please note: This authorization is for verbal information only; it does not include copies of records.
MyChart proxy access
Filling out a MyChart proxy access form gives others the ability to access an individual’s billing and health record on a single sign-in. There are two options for proxy access: Adult to adult, and adult to child.
Adult to adult proxy access
Adult to adult is for patients over the age of 18 who would like to grant access to another person over the age of 18.
Adult to child proxy access
Adult to child proxy access is for a parent or legal guardian to have access to a patient who is under 18 and not emancipated.