In order to protect the private health information of our patients and better understand their treatment needs, Wellstone Regional Hospital asks all new patients to complete the authorization form below. Please download and complete the form to bring with you to the hospital. You may also fax your completed form to 812-258-2023.
If you are a clinical professional seeking the medical records of your patient, please call 812-872-5224.
If you have any questions, concerns or requests regarding medical records, you may submit them using the form below.
We cannot offer diagnosis, counseling or recommendations online, but an Assessment and Referral specialist is available 24 hours a day, 7 days a week. Please call for a free assessment at 812-872-5224. If you are currently experiencing an emergency, please dial 911 or go to the nearest emergency room.