ET-2421 Form Active Employee / Retiree Request for Copies of My Medical Information Use this form to request to inspect or copy medical information maintained about you by ETF.
Network Health Major Health Systems • Froedtert Health• Children’s Hospital of Wisconsin - with locations in Milwaukee, Green Bay and Neenah• ThedaCare• Ascension Wisconsin• Bellin Health• Prevea Health• ProHealth Care (New in August 1, 2025) Full Service Areas Brown County Calumet County Dodge County Door County Fond Du Lac County Green Lake County Kenosha County Kewaunee County Manitowoc County Marinette County Menominee County Milwaukee County Oconto County Outagamie County Ozaukee County Racine County Shawano County Sheboygan County Washington County Waukesha County Waupaca County Waushara County Winnebago County Limited Service Areas Marquette County
Online Services Terms and Conditions of Use Agreement for Employers These terms constitute a legal binding agreement and govern an employer's use of ETF online service.
