Your Visit

UPMC Bedford Memorial

To request your records,

• Download this form.
• 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 yourself.
• Send the original to:
  

  UPMC Bedford Memorial
  Health Information Management Department 10455 Lincoln Highway
  Everett, PA  15537

Questions?

If you have questions, call
814-623-3507.