To request your record:
- Download the Authorization for Release of Protected Health Information.
- Fill out the form. Please type or print neatly. Be sure to complete both Part 1and Part 2.
- Sign and date the form.
- Make a copy for yourself.
- Send the original to:
UPMC, Release of Information Department
450 Melwood Ave - Lower Level
Pittsburgh, PA. 15213
- After we receive your request, we will send you an invoice for the cost of the records you requested. You should receive this invoice 7 to 10 days after we receive your request.
- Send payment as indicated on the invoice.
- After we receive payment, records will be mailed the next day.
Find additional information about requesting medical records from UPMC in the patients and visitors section of UPMC.com.