For Patients

Patient Forms

Below is a list of the most common forms used at Johnson County Healthcare Center. When applicable, please complete and print the forms prior to your appointment and bring them with you.

Common Patient Forms

Some specialty services may have additional forms specific to your visit.

Medical Records & Release of Information

A Release of Information (ROI) form must be completed in full before medical records can be released.

Please note:

All required fields must be completed
The form must include the patient’s signature
A copy of a valid photo ID is required

Medical records are maintained in accordance with state and federal regulations.

For questions related to medical records, please contact us directly.

Phone: 307-684-5521

Fax: 307-684-5404

Birth Certificates and Vital Records

Johnson County Healthcare Center does not issue birth certificates directly.

Wyoming Birth Certificates:

Visit the Wyoming Department of Health Vital Statistics page.

Out-of-State Birth Certificates:

For assistance, visit https://www.vitalchek.com/v/ or contact Wyoming Vital Records at 307-777-7591.

If you have questions or need assistance with forms, records, or patient information, please don’t hesitate to reach out. Our team is here to support you—every step of the way.