Health Information Management

The Health Information Management (HIM) department is responsible for organization, storage and retrieval of all patient health information. The department is available Monday through Friday from 8:00 a.m. to 4:30 p.m. and is located in the Central Business Office.

Woodlawn Hospital’s HIM Director also serves as Chief Privacy Officer. The HIM department complies with the HIPAA Privacy Standards and will not release any patient’s Protected Health Information (PHI) without his/her written authorization or as allowed by law. To obtain a copy of your Woodlawn Health medical records or to have a copy sent to another medical facility, please print and complete an Authorization to Disclose Health Information form. Bring this form and a photo ID to the HIM department for processing.

Additional medical forms, documents and information:
Notices of Privacy Practices for Protected Health Information
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Advance Directives

Advance directive forms help your family and physician understand your healthcare wishes in the event you lose the ability to make your own decisions. There are several types of advance directives. Please click on the form you want from below. Print and fill out the form according to the enclosed instructions. Each document should be reviewed, completed, signed and copies given to your family, physician, other caregivers, and attorney.

Your Right to Decide
Your Right to Decide in Spanish
Your Right to Decide is an informative brochure explain the purpose of advance directives.

Living Will Declaration
A Living Will expresses whether a person would want life-sustaining procedures to be withheld or withdrawn if, at some future time, they are unable to decide whether any medical procedure or intervention should be accepted or rejected.

Life-Prolonging Procedures Declaration
A Life-Prolonging Declaration mandates the implementation of all life-prolonging procedures, which would extend life.

Power of Attorney and Appointment of a Healthcare Representative
A Power of Attorney document appoints another person, called an agent, to make healthcare decisions in the event he or she becomes unable to make their own medical decisions. An Appointment for Healthcare Representative document appoints a healthcare representative to make medical decisions in the event he or she becomes incapacitated.

Indiana Do Not Resuscitate Declaration
A Do Not Resuscitate Declaration is a state specific form that specifies a persons desire to have cardiopulmonary resuscitation procedures withheld if experiencing cardiac or pulmonary failure.

Psychiatric Advance Directive
A Psychiatric Advance Directive (PAD) is a legal document with instructions about exactly what type of mental health treatments a person would prefer in an emergency.

If you have any questions pertaining to health information, please contact:

Woodlawn Health
Health Information Management
1400 E Ninth Street
Rochester, Indiana 46975
(574) 224-1140
Send an Email

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