Requesting Your Medical Records from UPMC Mercy

To request your 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. (Review the informational guide for completing the form)
Sign and date the form.
Make a copy for yourself.
Send the original to UPMC:

Mail the authorization to:
UPMC
450 Melwood Avenue – Lower Level
Release of Information Department
Pittsburgh, PA 15213

OR
Scan the form and email it to ROIRequest@upmc.edu.

After we receive your request, we will send you an invoice for the cost of the records you requested. You should receive this invoice 7 to 10 days after we receive your request.
Send payment as indicated on the invoice.
After we receive payment, records will be mailed the next day.