Our staff will be happy to assist you with requests for your medical records. All requests must be received in writing using one of the forms listed below:
Release medical Information from UHS: Authorization for Release
Complete this if you want UHS to release your medical information to another provider, or if you need copies of your records.
Obtain medical Information from another provider: Authorization to Obtain
Complete this if you want another provider to release your medical information to UHS.
Download and complete the appropriate form; sign and mail to:
University Health Services
150 Infirmary Way
Amherst, MA 01003-9288
Attn: Medical Release
Or, fax the form to (413) 577-5440.
Allow 10 business days for your request to be fulfilled.
There is no cost to send copies of medical records directly to a non-UHS healthcare provider. If copies are for a patient's personal use, for an insurance company or for legal purposes, a fee will be charged.
.50¢ per page up to 100 pages; .25¢ per page beyond 100 pages.
Additional fees may be added for postage. Payment is due upon receipt of records; cash, check and credit cards are accepted.