If you need your personal medical information for continuing health care, billing, insurance, or administrative purposes, you must complete and return this form:
If you would prefer, you can pick up a form by contacting the Health Information Management Release of Information staff at:
Rapid City Regional Hospital
Health Information Management
8 a.m. - 5 p.m., Monday through Friday
Returning the Completed Form
You are welcome to visit the Health Information Management Department at Rapid City Regional Hospital to begin the record request process and complete the Authorization for Disclosure of Medical Information during the hours listed above.
You may also print, complete and mail the Authorization for Disclosure of Medical Information form to:
Rapid City Regional Hospital HIM Department
Release of Information Services
353 Fairmont Blvd
Rapid City, SD 57701
or email the completed form to: RCRH Health Information Management
Birth Certificates and Paternity Affidavits
The Health Information Management Department (formerly Medical Records) at Rapid City Regional Hospital routinely prepares the South Dakota Certificate of Live Birth for all babies born at our hospital. Please contact us at 605-755-8170 for assistance with birth certificate and paternity affidavit information needs.
A legal and certified copy of your baby's birth certificate may be obtained from the Register of Deeds at the Pennington County Courthouse or from any courthouse in the State of South Dakota, for any child born in South Dakota. There is currently a fee of $15 payable to the courthouse for the certified birth certificate copy.