Medical records

Finding your medical records

Your UW Health medical record is available through your MyChart account. If you wish to request paper copies of your medical records, please review the following information.

Selecting medical records

UW Health Madison-area hospitals and clinics

For medical records and images when care was provided at one of the following locations, see requesting medical record options below:

  • American Family Children's Hospital

  • University Hospital

  • East Madison Hospital

  • UW Carbone Cancer Center

  • All UW Health clinics

UW Health Illinois-based hospitals and clinics

For medical records and images when care was provided by any hospital or clinic in Illinois, see requesting medical record options below.

UW Health other options

For medical records and images when care was provided at the following locations, follow the same process, but list the name of the location in the "Other Healthcare Organization" option, if you are using UW Health's authorization form:

  • Generations Fertility Care

  • Madison Surgery Center

  • Transformations Surgery Center

  • Wisconsin Sleep

  • UW Health Rehabilitation Hospital (offered as its own option on the UW Health authorization form)

Requesting medical records

You can request copies of your medical records from most UW Health sites (exceptions are noted below).

Option 1

  1. Complete and print the UW Health Authorization for Disclosure of Protected Health Information Form (pdf)

  2. Mail or fax the completed form to the following address:

    CiOX Health
    8501 Excelsior Dr.
    Madison, WI 53717
    Fax: (608) 203-4580

Option 2

MyChart users can complete a Release of Information request by selecting Other Resources and then selecting Request My Medical Records.

Please note: The UW Health 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.

Option 1

  1. Complete and print

    1. UW Health Authorization for Disclosure of Protected Health Information Form (pdf)

    2. Autorización Para Revelación de Información de Salud (pdf)

  2. Mail or fax the completed form to the following address:

    CiOX Health
    1401 E State St
    Rockford, IL 61104
    CiOX Fax: (779) 256-2411
    Continuation of Care Fax: (779) 256-2402

Option 2

MyChart users can complete a Release of Information request by logging into MyChart selecting Other Resources and then selecting Request My Medical Records.

Please note: UW Health SwedishAmerican 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 “Other” line in section 3 of this form. Records requests with sensitive information that are being directed to a third party are subject to require a witness signature. Please be aware that other authorizations may handle these protected conditions differently.

Cost

Cost for obtaining medical records

There is no charge for copies of your medical record requested from and sent  directly to other hospitals, clinics or physicians for further medical care. If the copies are needed for an upcoming doctor's appointment, the date of appointment should be documented on the request.

Due to the strict procedural and highly-regulated steps involved in the release of information process for requests directed by the patient, a fee is charged for this service:

Electronic or hybrid (part electronic, part paper)

$6.50 flat fee for electronic portion, plus:

  • If applicable, $0.07 per page for CIOX Health's labor cost to create and deliver the portion of record maintained in paper

  • Plus sales tax, as applicable.

$0.07 per page for CIOX Health's labor cost to create and deliver the portion of record maintained in paper, plus:

  • Plus, if applicable, the lower cost under state-regulated patient rates or $0.90 for CIOX Health's average labor cost to create and deliver the portion of record maintained electronically

  • Plus $0.05 per page for supplies (paper and toner)

  • Plus actual postage, if mailed

  • Plus sales tax, as applicable

Paper

$0.07 per page for CIOX Health's labor cost to create and deliver the portion of record maintained in paper, plus:

  • Postage

  • Plus sales tax, as applicable

$0.07 per page for CIOX Health's labor cost to create and deliver the portion of record maintained in paper, plus:

  • $0.05 per page for supplies (paper and toner)

  • Plus actual postage, if mailed

  • Plus sales tax, as applicable

Requests from persons other than the patient

Wisconsin state statutes regulate the fees applied to requesters other than the patient. For actual costs, please contact Health Information Management. A quote will be sent to indicate the total cost for the copies that must be paid in full prior to records being released.

When will I receive my copies?

The average turnaround time is five business days. Copies of medical records will be released once payment is received. The following methods of payment will be accepted:

  1. Make payment online via credit or debit card

  2. Mail payment to:

    CIOX Health, ATTN: A/R Department
    PO Box 19058
    Green Bay, WI 54307-9058

    Please make check or money order payable to CIOX Health.

  3. Make payment on-site at the UW Health CIOX Health at 8501 Excelsior Drive, Madison, WI, 53717. We accept credit or debit card, personal check or money order. (Walk-in locations are temporarily closed.)

  4. Make payment via credit card by calling our Central Office at (866) 420-7455 ext. 512.

Medical images

Obtaining medical images

About medical image release

Medical images are released separately from medical records. Medical images performed in Illinois or Wisconsin must be requested and released separately. For questions, please see options below.

Patient requests

Patients can request copies of medical images for procedures performed at a UW Health location.

For questions:

Option 1

Download and complete the following authorization form. Requested images will be mailed to the addressed listed in section 4 (disclosed to). Please provide the complete mailing address.

Mail or fax the form to:

Medical Imaging Department
UW Health SwedishAmerican Hospital
1402 E. State Street
Rockford, IL 61104
Fax: (815) 966-3979

Option 2

UW Health MyChart users can complete a Release of Information request by logging in to their MyChart account. Click on Menu, scroll down to Resources and then select Request My Medical Records.

These requests are submitted to the Medical Records Department automatically and will be forwarded.

Note: Due to occasional delays in forwarding these requests, this option is not recommended for urgent cases where overnight/expedited shipping or transfer is required.

Due to technical limitations, images are not available for viewing within MyChart. Image requests submitted through MyChart will be fulfilled by an imaging disc that is sent through the U.S. Postal Service.

Option 3

To request by phone that images be sent to other medical facilities, contact the Medical Imaging Department.

For questions

Option 1

Download and complete the UW Health Authorization for Disclosure of Protected Health Information Form (pdf) form. Requested images will be mailed to the address listed in section 4 (disclosed to). Please provide the complete mailing address.

Mail or fax the form to:

UW Health Image Management & Exchange
1212 Deming Way
Mail Code: 9704-1st Floor
Madison, WI 53717
Fax: (608) 263-0146

If faxed directly to Image Management & Exchange, standard requests will be processed by the next day and sent via First-Class U.S. Mail at no cost. Please allow additional time for delivery.

If necessary, overnight/expedited shipping via FedEx is available at a cost to the patient or receiving facility. Payor will need to obtain and provide a FedEx Shipping Account Number as FedEx does not accept credit card information to be written on forms. How to create a FedEx account

Option 2

UW Health MyChart users can complete a Release of Information request by logging in to their MyChart account. Click on Menu, scroll down to Resources and then select Request My Medical Records.

These requests are submitted to the Medical Records Department automatically and will be forwarded.

Note: Due to occasional delays in forwarding these requests, this option is not recommended for urgent cases where overnight/expedited shipping or transfer is required.

Due to technical limitations, images are not available for viewing within MyChart. Image requests submitted through MyChart will be fulfilled by an imaging disc that is sent through the U.S. Postal Service.

Option 3

Patients can request by phone that images be sent to other medical facilities only without filling out a MyChart request or the UW Health Authorization for Disclosure of Protected Health Information Form.

UW Health maintains an extensive electronic image exchange network with many medical institutions in Wisconsin and other large and notable healthcare organizations in surrounding states that can be used in place of mailing or hand-carrying image discs.

If a connection already exists with the other medical institution, Image Management & Exchange staff will send the images electronically.

Patients should be prepared to provide a complete mailing address at the time they call in case the facility does not have an existing electronic image transfer connection with UW Health.

Option 4

In Wisconsin, if options 1, 2 or 3 do not work for your specific circumstance, please call Image Management & Exchange at (608) 265-7118 to learn about alternative arrangements. Please be aware that patients no longer may pick-up images in person.

Outside health care provider requests

Outside healthcare providers may request medical images consistent with the HIPAA Privacy Rule's minimum necessary restriction from UW Health Image Management without a signed consent by filling out this form and faxing it along with the facility's fax cover sheet:

Outside Provider Request for Transfer of UW Health Medical Images (pdf)

Due to the amount of requests we receive on a daily basis, we require that these requests be submitted by fax. See appropriate fax number under medical image release. Images must be mailed directly to the medical facility that is requesting images.

Legal or insurance requests

Legal or insurance-related requests should be submitted by fax by the entity requesting the images. Please include your fax and phone number, a contact name and an email address for billing purposes. State statutes regulate the fees applied to requesters other than the patient. A quote will be sent securely to the contact person's email address and indicate the total cost for the copies that must be paid in full prior to records being released.

Imaging disc minimum system requirements

To view imaging discs sent from UW Health, your computer must meet the following requirements:

  • Pentium II processor

  • 512 MB RAM

  • Minimum display resolution 1024x768

  • Windows 2000, XP, Vista or Windows 7

  • Microsoft Internet Explorer 6.0 or higher

To view the images on a Mac operating system, a stand-alone viewer needs to be installed. A free one is included on imaging discs sent from Imaging Management. Unfortunately, UW Health is unable to provide technical support for this viewer. Please see the "How To Run On MAC" file on the disc for further instructions.

General billing information

There is no charge to send images via First-Class U.S. Mail for further medical care to patients, other hospitals, clinics or physicians. This applies to medical images released through Image Management & Exchange in Wisconsin. Requests for legal or insurance matters will be charged a per-disc fee.

Pathology reports and slides

Image Management & Exchange and the Medical Imaging Departments do not handle these types of requests. Please contact the appropriate Pathology Department. They will be able to assist with requests for pathology slides and reports for continued medical care or second opinion consultation.

  • Requests to forward pathology material for continued medical care at another facility require a written request from that facility.

  • Requests for second opinion consultation at another facility must be initiated by your physician and done in consultation with a surgical pathologist.

  • Pathology slides will need to be returned.

Pathology department Illinois : (779) 696-9730

Pathology Department Wisconsin: (608) 263-8443

Authorization and communication

Giving permission to communicate with others about your health care

Authorization for verbal communication

UW Health patients can authorize communication between UW Health provider(s) or other providers and another individual.

Complete and print the appropriate form.

Authorization for Verbal Communication and/or to Leave Voice Mail Messages (pdf)

Autorización para la Comunicación Verbal y/o para dejar mensajes en el buzón de voz (pdf)

Mail the completed form to the following address:

UW Health
Health Information Management
Attention: Release of Information
8501 Excelsior Dr.
Madison, WI 53717

Or fax the completed form to (608) 262-6663

Questions about release of information in Wisconsin? Call (608) 263-6030

Authorization for written communication

In Wisconsin, you can also authorize UW Health and/or your provider to participate in an exchange of both verbal and written information with another organization or person. To use this authorization, both verbal and written exchange of information must apply.

Complete and print the Authorization for Exchange of Verbal and Written Information form (pdf)

Mail the completed form to the following address:

UW Health
Health Information Management
Attention: Release of Information
8501 Excelsior Dr.
Madison, WI 53717

Or fax the completed form to (608) 262-6663.

Intercambio de Información Autorización para la Divulgación de Comunicación Verbal E Intercambio de Información Escrita (pdf)

If you would like to request hard copies (paper) of your medical records and radiology images, please submit two separate authorization requests.

Questions about release of information? Call (608) 263-6030.

Amendments

Requesting an amendment to your medical record

You can request an amendment of your medical record by:

  1. Completing and printing the UW Health Request of Amendment of the Medical Record (pdf) form. When completing the form, please make sure you provide all information in Section A.

  2. To submit an amendment for Illinois or Wisconsin, mail or fax the completed form to the following address:

    UW Health Health Information Management
    Attention: Patient Amendments
    8501 Excelsior Dr. Room 116
    Madison, WI 53717
    Fax: (608) 203-1440

Questions

For questions about amendments, please call (608) 203-1449 between 8 a.m. - 4:30 p.m., Monday through Friday.

Frequently asked questions about requests to amend medical records

There is no charge for requesting an amendment to your medical record.

Your request will be reviewed and approved or denied within 60 days of receipt of your amendment request. If the request involves a mental health diagnosis, it will be responded to within 30 days. If the request takes longer than the allotted time, an extension letter will be sent to you within an appropriate time frame explaining the reason for the extension.

Reasons a request for amendment may be denied include:

  • UW Health did not create the information and you must return to the source to amend their document

  • The information is complete and accurate as reviewed by the author.

  • The author of the document is no longer employed by UW Health.

  • The information is contained in psychotherapy notes.

  • The information is compiled in anticipation of or for use in any civil, criminal or administrative action or proceeding.

  • The information is not subject to disclosure to you under the Clinical Laboratory Improvements Amendments of 1988 (42 U.S.C. § 263a).

  • You did not provide enough information to complete the request.

  • The request is regarding billing information and needs to be redirected back to the billing department.

If your request is denied, you will receive a written explanation of the denial. If you disagree with the explanation, you can submit a one-page, written statement of disagreement or you can ask that your request for amendment and explanation of the denial be included in any future disclosure of the pertinent medical record information.

You may schedule a viewing of your medical records with the UW Health Release of Information Department by calling (608) 263-6030.

You may request a copy of your UW Health medical records by submitting:

For care received in Wisconsin:

Complete and submit the UW Health Authorization for Disclosure of Protected Health Information Form (pdf)

For care received in Illinois:

Complete and submit the UW Health Authorization for Disclosure of Protected Health Information Form (pdf) | Autorización Para Revelación de Información de Salud (pdf)

Please note, there may be a charge for your records.

You can request that any information contained in multiple locations within your medical record be amended per your request. Please note, additional information may be needed when specific dates are not indicated.

Providing a copy of the document(s) in question, strike through the information you do not agree with, and writing in what you believe to be the correct information is very helpful and can expedite the process. Additionally, using one form for each requested amendment is helpful in expediting the process when you are requesting multiple amendments.

The approved form and the amended document(s) are sent to you via U.S. mail.

The author of the document decided to amend part of your request, but not all. The provider will complete Section C of the amendment form indicating the reason for partial approval.

If the author of the document has left the organization, the document can no longer be amended. You are welcome to write a one-page statement of disagreement to be included in any future disclosures of the document.

Once the request has been denied, your option is to submit a statement of disagreement.

The information contained within the UW Health record cannot be permanently removed in its entirety. You can request that specific information is amended or removed, but the entire record cannot be removed.

Print and complete the Patient Request For Legal Gender Inclusion/Legal Gender Change form (pdf). Mail or fax the completed form to:

UW Health Information Management
Attn: HIM Identity
8501 Excelsior Dr. 2nd floor
Madison, WI 53717
Fax: (608) 203-1032