Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, you have the right to access, inspect and/or obtain a copy of your protected health information (PHI), including:

• Name
• Address
• Important dates (birth date, admission date, discharge date, etc.)
• Medical record number
• Social security number
• Certificate/license number
• Full-face photographic images
• Other identifiers

If you would like a copy of your protected health information, our Medical Records Department can help.

• We can be reached at 210-358-3532.
• We are available Monday through Friday, 8 a.m. to 5 p.m.

Patients may obtain a complimentary set of up to 10 pages of their medical record from a Medical Records location.

Please send you requests for records with an Authorization To Release Form. You can also pick up this form at all University Health locations in the Medical Records Department.

Mail your Authorization To Release Form to:

University Health 
Attention: Release of Information
Medical Records Department/MS-26-2
4502 Medical Drive
San Antonio, TX 78229-4496

You can also fax your request at 210-358-5936.

For status of medical record requests and other information, please call 210-358-3532.

The first 10 pages of your medical record are free at a Medical Records location. A fee per printed page will be applied to any pages after that.

• $.25 cents per page for the first 10 pages after the 10 complementary pages
• $.15 cents per page thereafter

Medical records may also be requested on a CD for $14.95 plus shipping.

If we send you a pre-payment form, please mail your pre-payment to:

University Health 
Medical Records Department/MS-26-2
4502 Medical Drive
San Antonio, TX 78229-4496

Release of medical records requires a signature. Please download and fill out any of these necessary forms to obtain your medical records.

Authorization for Release of Behavioral Health Records

Authorization for Release of Behavioral Health Records (Español)

Authorization to Access Inspect and/or Obtain a Copy of Protected Health

Authorization to Access Inspect and/or Obtain a Copy of Protected Health (Español)

Authorization to Access Inspect and/or Obtain a Copy of Protected Health (Adolescent 13-17)

Authorization to Allow Designated University Health Employee to Access, Inspect, and/or Obtain a Copy of Health Information

Authorization to Request Health Information From Another Health Care Provider or Facility

Authorization to Use and Disclose Protected Health Information - Detention Health Care Services

Proxy Request and Authorization Form

Proxy Request and Authorization Form (Español)

Request for Amendment of Protected Health Information (Español)

Request for an Accounting of Disclosures

Request for an Accounting of Disclosures (Español)

Request for Restrictions On Use/Disclosure of Protected Health Information

Request for Restrictions On Use/Disclosure of Protected Health Information (Español)

Revocation of Authorization for Release of Protected Health Information

Revocation of Authorization for Release of Protected Health Information (Español)