Here is a list of the most common forms that are used here at the Campbell County Memorial Hospital. Please fill out and print them to bring them along on your visit.

If you have any questions call 307.688.1301

If you have any questions concerning Vital Records/Birth Certificates please contact Vital Records at 307.777.7591 or visit them at www.vitalcheck.com


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Release of Information Form

Birth Certificate - VitalCheck.com

To Whom It May Concern:

             The Release of Information Form must be complete in it's entirety before your medical records are released. ( All highlighted areas, if filling release out online).  We will need the signature of the patient along with a copy of their photo ID.  Lastly, we will need a witness signature.  (It can be anybody over the age of 18).

If you have any questions please do not hesitate to call.  If the release is not filled out correctly it may delay the records from being sent.

Thank you,

Medical Records

307-688-1300

307-688-1390 FAX