To share your information or receive access to another person’s information, you must complete the appropriate proxy authorization forms which are available from any Ridgeview health care provider.
Minor Patient Proxy Authorization
Adult Patient Proxy Authorization
Return form to Health Information Management Department:
E-mail:
proxyform@ridgeviewmedical.org OR Fax: 952-442-6037
OR Mail to: Ridgeview, Attn: ROI, 500 S Maple St, Waconia, MN 55387