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Requesting Your Records From the UPMC Home Assessment Response Team (HART)

To request your medical records

  1. Download the Authorization for the Release of Protected Health Information Form (PDF).
  2. Fill out the form. Be sure to complete both parts 1 and 2.
  3. Sign and date the form.
  4. Make a copy for yourself.
  5. Mail, drop off, or email the original authorization form to UPMC.

Mail the form to:

UPMC Release of Information Department
450 Melwood Avenue - Lower Level
Pittsburgh, PA 15213

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

Medical Records Questions?

If you have questions call 412-802-0100.

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.