Requesting Your Medical Records from UPMC Bedford Memorial
To request your medical records:
- Download the Authorization for the Release of Protected Health Information Form (PDF).
- Fill out the form. Please type or print neatly. Be sure to complete both Part 1 and Part 2.
- Sign and date the form.
- Make a copy for your records.
Mail the original authorization form to:
UPMC Bedford Memorial
Health Information Management Department
10455 Lincoln Highway
Everett, PA 15537
After We Receive Your Request for Medical Records
- After we receive your authorization form, we will send you an invoice for the cost of your records. You should get this invoice within 7 and 10 days from when we received your request.
- Send payment as indicated on the invoice.
- After we receive payment, we will mail your records the next day.