University of Rochester


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Last modified: Thursday, 09-Mar-2017 16:00:25 EST

University Health Service (UHS)

Medical / Immunization Records
Authorization for the Release of Patient Information

PLEASE NOTE: Please call 585-275-2605 for the release of your medical or immunization records from the University of Rochester Medical Center (URMC) or Strong Memorial Hospital.


Medical information is routinely exchanged between healthcare professionals as deemed necessary by your healthcare provider to assure your safe, continuous care.

Release of your Immunization History:

If you are, or have been, a University of Rochester student or a UHS primary care patient, you can request a copy of your immunization history by submitting your request via e-mail to hhf@uhs.rochester.edu. No other form or signature is required. Immunization records will be forwarded to you by email, fax, or mail. When requesting your immunization history, please include your name, date of birth, current address, and phone number. Requests are generally processed within 2-5 business days. There is no charge to request your immunization history.

Release of Your UHS Medical Record:

If you are, or have been, a University of Rochester student or a UHS primary care patient, you can request a copy of your UHS medical record from the University Health Service. You will need to complete the UHS Authorization for Release of Medical Information Form before your records can be released by UHS. Please write to hhf@uhs.rochester.edu to request the form. Once you have completed the form, it can be returned via e-mail, fax, mail, or hand delivery.
Fees: There is no charge for medical records and immunization records that are sent (via fax or mail) directly to another doctor's office or medical care provider. There is a charge for records requested for personal reasons. The fee is $.75 per page or a flat $10.00 for 15 pages or less. Pre-payment is required prior to the release of the records. If requesting records for reasons other than direct medical care (e.g., insurance companies, attorneys), the requestor is responsible for payment of records.

Release of Your Medical Records from another Provider/Health Care Facility:

If you are a University of Rochester student or a UHS primary care patient, you can request a copy of your medical records from providers outside of the UHS system by completing the UHS Authorization for Release of Medical Information Form. The information you are requesting can either be sent to you or to UHS where it can become part of your UHS medical record. Please write to hhf@uhs.rochester.edu to request the form. Once you have completed the form, it can be returned via e-mail, fax, mail, or hand delivery. Charges may be associated with your request for your medical records. It is recommended that you check with the health care provider or medical facility to inquire about the fees associated with your request to have your medical record released.

Contact

E-mail:     hhf@uhs.rochester.edu
Phone:      (585) 275-1158
Fax:          (585) 276-0149
Mail:         University Health Service
                 Attn: UHS Medical Record Request
                 Box 270617, 738 Library Road
                 Rochester, New York 14627