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Requesting Your Medical Records from UPMC Bedford

To request your medical records:

  1. Download the Authorization for the Release of Protected Health Information Form (PDF).
  2. Fill out the form. Please type or print neatly. Be sure to complete both Part 1 and Part 2.
  3. Sign and date the form.
  4. Make a copy for your records.

Mail the original authorization form to:

UPMC Bedford
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.

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