Forms

To Request Hospital Medical Information

Download the Authorization for Disclosure of Protected Health Information. Complete the form and mail it to Sanford Luverne Medical Center, attention HIM department, 1600 N. Kniss Ave, Luverne, MN 56156-1067.

To Request Clinic Medical Information

Download the Authorization for Disclosure of Protected Health Information. Complete the form and mail it to Sanford Luverne Clinic, 1601 Sioux Valley Drive, Luverne, MN 56156.