Downloadable and Printable Authorization for Disclosure of Health Information Form
My.richlandhospital.com is an easy way to access your healthcare information online. My.richlandhospital.com is available through a secure internet connection at http://my.richlandhospital.com. It can be accessed, using your password, on any computer with internet access including tablets and smart phones.
To learn more, read the information that follows.
Note: If you already have a My.richlandhospital.com account, you can log in by clicking the green button below.
Your Health Information
The information on My.richlandhospital.com is the most accurate and up-to-date information available based on your last Richland Hospital visit. (Medical visits at other facilities, including Richland Medical Center, will not appear on My.richlandhospital.com.)
On My.richlandhospital.com You Can:
- Look at your health summary
- Review your visit history with Richland Hospital
- View information from each of your Richland Hospital visits
- Read and print instructions that were given to you before you left the hospital
- Look at your Lab and x-ray results from hospital visits
- Review the list of your medication and allergy as listed at your last hospital visit
- Request an appointment for some hospital services
- Review your profile information and update it when necessary
You Can Give Others Access to Your Health Record
My.richlandhospital.com allows you to set-up a proxy authorizing another person to access your health record. The process requires your consent and the consent of the person you permitted to access to your health information. Talk with the Richland Hospital Health Information Management department about becoming a proxy for your child’s account or to give another adult access to your account.*
Before You Enroll
You Will Need a Personal Email Account
Each My.richlandhospital.com account must be tied to an individual’s email account. No two portals can have the same email address.
You Will Need your Medical Record Number
Contact Richland Hospital’s HIM Department at (608) 647-6321 extension 2030 to get your enrollment information.
- Have your enrollment information from the HIM Department and your email address handy.
- Click the Request an Account button below.
- Complete the form on the Enrollment Request page. When ready, click “Submit Enrollment Request” button.
- Access your email for your one-time user name, password and link to the Portal
- If you do not receive an email with your initial user name and password, check your spam folder.
- Click on the link provided via email to access the My.richlandhospital.com Portal.
- Enter your one-time user name, password and security question. Click Log In.
Select and enter a new user name and password. Be sure to keep this information in safe place where you can locate it again.
- Explore My.richlandhospital.com!
Logging in and using My.richlandhospital.com
Now that you have enrolled, accessing My.richlandhospital.com is easy. Simply locate one of the following links:
- Click the button below.
- Most pages on this Richland Hospital site (with the exception of the Home page) has a sidebar area with a log in button that will take you directly to My.richlandhospital.com
Once you have connected to My.richlandhospital.com, log in using the user name and password you set up when you self-enrolled.
Select where you want to go from your Home page.
My.richlandhospital.com makes it possible for you to be an active manager in your healthcare.
If you need assistance using My.richlandhospital.com, please contact the Health Information Management Department (HIM) at the Richland Hospital.
Phone: (608) 647-6321 or Toll free at 1 (888) 467-7485. Ask for Extension 2030
HIM is available Monday through Friday, 8:00 am – 4:30 pm
If you are calling on a weekend or holiday, your message will be returned on the next business day.
How to Become a Proxy With Access to Another’s Account
To request access to another person’s My.richlandhospital.com account, you must first activate an account for yourself. Once you have activated your account, complete the appropriate forms on this site requesting authorization. Access to other accounts is tightly controlled and only granted with appropriate authorization and consent forms on file with The Richland Hospital, Inc. All requests are reviewed by Richland Hospital’s medical records department and will be processed in 7 – 10 days.
What information is available when accessing another person’s account?
When accessing accounts for children age 0-11, or adults age 18 or older (such as a spouse, parent, or other person you care for), all standard features are available. This includes:
- Test Results
- Medications: View current medications
- Allergies: View current allergies
- Immunizations: View all immunizations
- Health Issues: View current health issues when shared by the patient’s provider
- Appointment scheduling for routine, simple appointments at Richland Hospital
- View future and past appointments scheduled at Richland Hospital
When accessing accounts for children age 12-17 the following restrictions apply:
- Available features: Allergies, Immunizations, Secure Messaging, and Scheduling for routine, simple appointment in primary care
- Not available: Test results, Medications, Health Issues, Medications, view Future and Past Appointments
My.richlandhospital.com is a free, voluntary service offered by The Richland Hospital, Inc. as a convenience and courtesy to patients who receive their care from us.