Requesting Your Medical Records from UPMC Western Psychiatric Hospital

To request your records from UPMC Western Psychiatric Hospital:

Download the Authorization for the Release of Protected Health Information Form (PDF).
Please type or print neatly.
View for step by step instructions.
Sign and date the form.
Make a copy for yourself.
Mail the original to:

UPMC Western Psychiatric Hospital
Health Information Management Department
Suite A-34
3811 O'Hara Street
Pittsburgh, PA 15213

OR

Fax to:
UPMC Western Psychiatric Hospital HIM Department
ROI
4122-586-9280

OR

Email to:
wpicroi@upmc.edu

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