A patient or their legal representative may request a copy of the patient’s medical record, or request a copy to be sent to another party, by completing a Release of Information form. Completion of this form allows UT Physicians to transfer the medical record in compliance with the requirements for protection of patient healthcare information.
Patients may request a copy of their medical records clicking the button below:
Patients may also request a copy of their records using one of the following options:
- Requesting at a UT Physicians office
- Visiting UT Physicians Health Information Management Department located in the UT Professional Building, Suite LL135, 6410 Fannin St., Houston, TX 77030
- Calling UT Physicians Health Information Management Department at 832-325-6543
- Downloading the form below (requires Adobe Acrobat)
There may be a charge for obtaining copies of the medical record.
Also, using this form, you can request that a different provider send their records to UT Physicians. Universal Authorization for the Use and Disclosure of Protected Health Information
For additional information about medical records at UT Physicians, please call us at (832) 325-6543.