Records Release

Request for Medical Records Release

Our primary function is to manage patient medical records during a student’s tenure at the University.   Each record is necessary to provide quality healthcare to each patient.   Since medical records contain personal information, we adhere to all laws and guidelines which govern the use and disclosure of such information.

A patient may receive a hard copy of his/her medical records or may have a copy forwarded to his or her personal healthcare provider by completing the necessary authorization form (available at Student Health Service).   A nominal fee may be charged.

CLICK HERE  to print out the Authorization for Release of Medical Records.

Please fill out the Release form and return it to the location below::

U.S. MAIL: University of Pittsburgh
Student Health Service
Nordenberg Hall – Wellness Center
119 University Place
Pittsburgh, PA. 15260
FAX: 412.383.1820
Delivery in Person: Do NOT Email. We cannot accept any Medical Release forms via EMAIL !!