Ascension Medical Group: Locating Your MRN
This document provides essential instructions to access your Medical Record Number (MRN) for CSMConnect self-enrollment. Users will find practical steps and examples to easily locate their MRN. Aimed at improving patient accessibility to medical records, this guide is a valuable resource.
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How do I fill this out?
To fill out this form, ensure you have your Medical Record Number (MRN) on hand. Follow the provided steps to locate your MRN accurately. If you encounter difficulties, contact the registration staff for assistance.

How to fill out the Ascension Medical Group: Locating Your MRN?
1
Check your most recent clinic or hospital discharge summary for your MRN.
2
Locate your MRN on your billing statement by identifying the Patient Account #.
3
Access your previous billing statement through the online portal if applicable.
4
Enter the MRN without any letters or leading zeros during self-enrollment.
5
If you require further help, reach out to clinic registration personnel.
Who needs the Ascension Medical Group: Locating Your MRN?
1
New patients who need to enroll in the CSMConnect portal.
2
Patients looking to access their medical records efficiently.
3
Individuals managing billing inquiries regarding their accounts.
4
Patients wishing to participate in telehealth options.
5
Family members needing access to a loved one's medical information.
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What are the instructions for submitting this form?
To submit this form, please send a scanned copy to support@ascension.org, or fax it to (414) 270-1234. You may also fill it out online through your CSMConnect account. For physical submissions, please address your envelope to Ascension Medical Group, 2301 North Lake Drive, Milwaukee, WI 53211. For best practice, always keep a copy for your records.
What are the important dates for this form in 2024 and 2025?
For 2024, please make note of any updates regarding MRN access, as new regulations may apply. In 2025, the annual review of patient records will take place, ensuring the accuracy of your information. Stay informed about these important updates to ensure seamless access to your medical records.

What is the purpose of this form?
The primary purpose of this form is to provide patients with an easy method to retrieve their Medical Record Number (MRN). This enables self-enrollment into the CSMConnect portal, enhancing patient engagement with personal health information. The form also aims to streamline the process of accessing medical records for billing and service inquiries.

Tell me about this form and its components and fields line-by-line.

- 1. Patient Name: Enter the full name as registered in the medical records.
- 2. Date of Birth: Provide your date of birth for verification purposes.
- 3. Patient Account Number: Locate this number on your billing statements.
- 4. MRN: Input your Medical Record Number without letters or leading zeros.
- 5. Contact Details: Provide your current contact information for follow-up.
What happens if I fail to submit this form?
Failing to submit this form may lead to delays in your access to important medical information. Additionally, it could impede timely communication regarding your medical treatments and billing. It is essential to complete the form accurately to avoid further complications.
- Access Delays: Delays in accessing your medical records and treatment information.
- Billing Issues: Possible confusion or errors in your billing statements.
- Missed Appointments: Risk of not being informed about upcoming medical appointments.
How do I know when to use this form?

- 1. Portal Enrollment: To enroll in the CSMConnect portal for accessing your records.
- 2. Billing Access: To retrieve your MRN for resolving billing discrepancies.
- 3. Patient Inquiries: For inquiries regarding appointments and medical histories.
Frequently Asked Questions
How do I locate my MRN?
You can find your MRN on your latest clinic or hospital summaries.
What should I do if I can’t find my MRN?
If you're unable to locate your MRN, please contact the registration staff for assistance.
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Simply use our electronic signature feature to add your signature conveniently.
Is it possible to share my edited PDF?
Yes, you can share your PDFs easily via email or social platforms.
What if I need help during the process?
Feel free to reach out to our support staff for help navigating the tools.
Are there any submission deadlines for this form?
Please consult our important dates section for specific deadlines.
What if I have a billing question?
You can locate billing information on your Patient Account statements.
Can family members assist with this process?
Yes, family members can help locate and fill out the form as needed.
Are individual billings separate?
Yes, each patient's billing is handled separately for accuracy.
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