Obtaining Medical Records from UW Hospital and Clinics
Contact Information
Health Information Management
8501 Excelsior Drive, Room 101
Madison, WI 53717
Walk-in Hours
Monday - Friday
8am - 4:15pm
(608) 263-6030, option 5 - Release of Information
Monday - Friday
8am - 5pm
If you would like to request copies of your medical records but are unsure whether the clinic is managed by UW Hospital and Clinics or the UW Medical Foundation, please refer to Obtaining Medical Records: UW Health Clinics Listing to find out where to direct your inquiry.
To Request Your UW Hospital and Clinics Records
An authorization signed by the patient is required for release of information from the medical record. You may use the UW Hospital and Clinics (UWHC) Authorization Form or other healthcare facility authorization, which meets Wisconsin and HIPAA (Health Insurance Portability and Accountability Act) regulations. This includes the following core elements:
- Patient name
- Date of birth
- Name of the person/classes of person(s) who is to release the information
- Name/address where you would like records sent
- Type of records and dates that you want copied (clinic notes, radiology reports, etc.)
- Reason you need the records (further medical care, personal use, insurance, attorney, disability determination, workers' compensation, etc.)
- The expiration date or event in which the authorization is valid
- This request must be signed and dated by the patient or the parent of a patient under age 18, or the legal guardian of the patient
In addition, HIPAA regulations require that the following information must also be on the authorization:
- A statement of the individual's right to revoke the authorization in writing
- A statement about the ability or inability of UWHC to condition treatment, payment, enrollment, or eligibility for benefits on the authorization
- A statement that information used or disclosed pursuant to the authorization may be subject to redisclosure by the recipient and may no longer be protected by the rule
Please Note: The UWHC authorization DOES authorize release of records containing psychiatric diagnoses or treatment, alcohol or drug abuse information, or HIV or AIDS information, unless you specify any exceptions on the line above the signature line. Please be aware that other authorizations may handle these protected conditions differently.
Authorization Forms to Request Your Medical Records
You can request copies of your medical records for clinics managed by the UW Hospital and Clinics by downloading and completing one of the following:
- UW Hospital and Clinics Medical Records Authorization (pdf)
- UW Hospital and Clinics Permission for Verbal Communication (pdf)
Where to Send Your Medical Records Request
Mail your completed authorization form to the Health Information Services Department at the following address:
University of Wisconsin Hospital and Clinics
Health Information Management
Attention: Release of Information/MMRA
8501 Excelsior Dr., Room 101
Madison, Wisconsin 53717
Fax: (608) 262-6663
Cost for Obtaining Medical Records
There is no charge for copies of your medical record mailed directly to other hospitals, clinics or physicians for further medical care. If your request is for copies needed for an upcoming doctor's appointment, please indicate the date of your appointment on the request. Payment for copies for other reasons is required. A cost of $0.30 per page plus tax and actual postage will be charged for patient requests for non-healthcare purposes. (Note: Wisconsin State Statute regulates the fees applied to requesters other than the patient - for actual costs, please contact HIM). You will be mailed a quote to indicate the total cost for the copies that must be paid in full prior to records being sent.
When Will My Copies Be Mailed?
When Will My Copies Be Mailed?
The average turnaround time is 2 weeks. Copies of medical records will be mailed once payment is received. The following three methods of payment will be accepted:
- Mail payment to Midwest Medical Record Association, Inc at 1701 East Woodfield Rd. Suite 1100, Schaumburg, IL, 60173. Please make checks payable to MMRA.
- Make payment on site at the University of Wisconsin Hospital and Clinics Health Information Management at 8501 Excelsior Drive, Room 101, Madison, WI, 53717. Please note that if paying by cash, we ask that you provide us with exact change.
- Make payment via credit card by calling our Central Office at (847) 413-9660.
