Medical Records Requests

Your medical record is the physical property of UMass Memorial Medical Center; however, you have the right to review the record and to obtain a copy.

When you are discharged from the Medical Center, your medical record still must be completed by all providers involved in your care prior to being copied and released to you. This process can take up to 30 days. When needed, information may be released to a physician or medical facility for any follow up and continued care you receive.

If you wish to receive a copy of your medical records or have the records forwarded to another party, please complete the Authorization for the Disclosure of Protected Health Information Form below. The forms are provided in both English and Spanish. For assistance with filling out the form, please refer to the instructions provided below the forms.

Authorization for the Disclosure of Protected Health Information (English)
Instructions to Complete Form (English)

Authorization for the Disclosure of Protected Health Information (Spanish)
Instructions to Complete Form (Spanish)

 

There is a fee to obtain copies of your medical records, except for copies sent to a health care provider. Learn more. Please include the name, address, and/or fax number of the provider in the appropriate section of the Authorization for the Disclosure of Protected Health Information Form.

Upon receipt of a signed Authorization Form, UMass Memorial Medical Center will process the request within seven to 10 business days and send an invoice for payment of the copies.

If you have questions, please call Health Information Management at 508-334-5700 or send an email to: medicalrecords.medctr@umassmemorial.org.