For Patients

Obtaining Medical Records

A patient or his/her legal representative may request a copy of his/her medical record, or for a copy to be sent to another party, by completing a Release of Information form (Authorization for the Use and Disclosure of Protected Health Information).

Completion of this form allows UT Physicians to transfer the medical record in compliance with the requirements for protection of patient health care information (HIPAA).

Patients may obtain a copy of the Release of Information form by:

	Requesting one from the UT Physicians office in which they received medical care.
	Visiting UT Physician's Health Information Management Department located in The University of Texas Health Science Center Professional Building, suite LL100 (basement suite 100).
	Calling UT Physicians Health Information Management Department at 832-325-6543.
	Download the form - Requires Adobe Acrobat ( Download the latest version of Adobe Reader free)
	Consiga la forma en espanõl - Requiere Adobe Acrobat ( Descargar la última versión de Adobe Reader gratis)

There may be a charge for duplication and transfer of a medical record.
For additional information, please call UT Physicians Medical Records Department at 832-325-6543.

 

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Last Date Updated on Friday, November 09, 2007