Your Visit

UPMC Mercy

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 Mercy
  Health Information Management Department 1400 Locust Street
  Pittsburgh, PA 15219

Questions?

If you have questions, call
412-232-7213.