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UW Health SMPH

Obtaining Medical Records from UW Hospital and Clinics

Questions

Please call Health Information Management at (608) 263-6030, option 5, between 8am and 5p, Monday through Friday

Walk-in Hours

8am-4:15PM, Monday through Friday, at 8501 Excelsior Drive, Madison

Map (pdf) 

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:
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: WI 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.

 

Where to Send Your Medical Records Request

 

Mail your completed authorization form to:

University of Wisconsin Hospital and Clinics
Health Information Management
Attention: Release of Information/IOD 
8501 Excelsior Dr., Room 101
Madison, Wisconsin 53717
Fax: (608) 262-6663
When Will My Copies Be Mailed?

The average turnaround time is five business days. Copies of medical records will be mailed once payment is received. The following methods of payment will be accepted:
  1. Make payment online via credit or debit card at https://payportal.iodincorporated.com
  2. Mail payment to IOD Incorporated ATTN: A/R Department, PO Box 19058 Green Bay, WI 54307-9058. Please make check or money order payable to IOD Incorporated
  3. Make payment on site at the University of Wisconsin Hospital and Clinics Health Information Management at 8501 Excelsior Drive, Room 101, Madison, WI, 53717. We accept credit or debit card, personal check or money order 
  4. Make payment via credit card by calling our Central Office at (866) 420-7455, ext. 512.