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.

Costs

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.

Charges

 .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.