Customers of the Sauk Trails Pharmacy may obtain refills by contacting either the Capitol Pharmacy at (608) 257-9732, or the Hatchery Hills Pharmacy at (608) 661-7242. Members needing an X-ray or Lab services can have these completed at Capitol or Hatchery Hill Clinics. Note that these services are also available on weekends at the Capitol Clinic.
Sauk Trails members who need to schedule a new appointment should use GHCMyChart or call 831-1766. Anyone with questions can call (608) 828-4853 or toll-free at (800) 605-4327 to speak to Member Services.
GHC-SCW patients with urgent needs are asked to call the GHC-SCW NurseConnect line at (608) 661-7350. If you have an emergency, call 911.
Stay tuned to your email and check ghcscw.com for further updates.
Please download and print these commonly requested forms. If you need additional assistance, please contact member services at (608) 828-4853 or (800) 605-4327. We’re happy to send forms by email or the US Postal Service.
Please note that as of Aug. 23, 2016, our Release of Information vendor CIOX, requires payment for medical records. If you have questions, please call CIOX Health toll-free at (800) 367-1500.
CIOX Health's copy fees - Patient UseMedical Record Amendment FormAuthorization for CommunicationAuthorization to Receive Medical Information From Another FacilityAuthorization to Receive Medical Records From Another Facility (Español)Authorization to Release Medical Information From GHC-SCWAuthorization to Release Medical Records from GHC-SCW (Español)Authorization to Release Payment InformationPersonal Representative FormPower of Attorney for Health CarePower of Attorney for FinancesRestriction FormRevocation Form
Authorization for GHC-SCW to Provide Care to Your Minor Child In the Absence of a Parent Medical History Form (Adult – English)Medical History Form (Pediatrics – English)Medical History Form (Adult – Español)Medical History Form (Pediatrics – Español)Consent for Non-Emergency Care & Treatment of Minors to Temporary Caregiver(s)Consent for Non-Emergency Care & Treatment of Minors to Temporary Caregiver(s) (Español)Formulary Exception Request Form Prescription Drug Claim Form for Direct Member Reimbursement
GHC-SCW Member Appeal Form GHC-SCW Provider Appeal Form
(608) 828-4853 or (800) 605-4327, request Member ServicesMon. – Fri., 8 a.m. – 5 p.m.Email Member Services
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