Health Records

To transfer your records, complete the appropriate form below.
You can do this online or by downloading and filling in the form by hand.

If you are currently a patient wishing to transfer healthcare services to CHC/SEK, it is necessary to get your approval for the transfer of your records to CHC/SEK. Parents and guardians may complete a release of medical records for patients who are under 18 years old.

All CHC/SEK Clinic Patients

Complete the online version

Release of Information

Demographics Form

Submit Forms

Downloaded forms can be returned to clinic staff, faxed to 620-231-5062, or mailed to:
P.O. Box 1832
Pittsburg, KS 66762