Requesting Your Medical Records from UPMC Lock Haven

There are 2 main ways you can get access to your health records from UPMC Lock Haven:

• Log in to MyUPMC. If you don't have an account yet, sign up for MyUPMC for free.
• Fill out a records release form and fax or mail it to the address below.

To get records from your doctor, contact your doctor's office.

Fill Out a UPMC Lock Haven Medical Records Release Form

1. Download the Authorization for the Release of Protected Health Information Form (PDF).
2. Complete the form.
• Check off UPMC Lock Haven.
• Fill in the patient and requestor information.
• Select the types of records and specific information you want us to release.
• Include the dates of service.
3. Sign and date the form.
4. Make a copy for yourself.
5. Mail or fax the original form to UPMC.

Mail or fax your release form

For care you received at UPMC Lock Haven:

UPMC Williamsport Health Records Department
Attn: Release of Information
700 High St.
Williamsport, PA 17701

Tel: 570-321-2745, Option 1
Fax: 570-321-2138

For imaging records from UPMC Lock Haven radiology services:

UPMC Williamsport Radiology Department
700 High St.
Williamsport, PA 17701

570-321-2500

After We Receive Your Request for Medical Records

After we receive your release form, we'll send you an invoice for the cost of your records. You should get this invoice within 7 to 10 days from when we received your request.

Send payment as indicated on the invoice.

UPMC Lock Haven charges modest, cost-based fees for copies of medical records. We use the Pa. Department of Health's charges for medical records fee schedule (PDF).

Make Changes to Your UPMC Lock Haven Health Records

Every UPMC patient can request a change to their health record.

To amend your record:

• Download and complete the UPMC Lock Haven patient amendment to PHI form (PDF).
• Mail your form to the proper medical records department. The process may take up to 60 days.

Please note, we may consult your doctor before making changes to your record. UPMC can also deny the request if we deem your record correct and complete.

If you have any questions, call UPMC Medical Records at 412-802-0100.