Medical Records Request

You have the right to review your medical record and request a copy. 

Medical Records Requests

For questions about or requests for medical records, please contact the Health Information Management (HIM) Department at 508-334-5700 or email medctrmr@umassmemorial.org.

Correcting Your Medical Record If you believe information in your medical record is incorrect, please complete the "Request to Amend Protected Health Information" form.

Ownership and Access to Medical Records Your medical record is the property of the UMass Memorial Health facility where you received care, but you have the right to review and get a copy.

Medical Record Completion Process After discharge, all providers involved in your care need to complete your medical record before it can be copied or released, which may take up to 30 days. Your information can be shared with another physician or facility for follow-up care.

How to Request Your Records

Through MyChart: Sign up for a MyChart account to request a copy of your records for personal use. We cannot send records to third parties via MyChart.

Through Authorization Form: If you need a copy of your records or want them sent to someone else, please complete the Authorization for Disclosure of Protected Health Information form in your preferred language below:

• English
• Spanish
• Portuguese
• Albanian
• Vietnamese 
• Arabic
   

Completing the Authorization Form: 

1. Top right corner: Include your name, date of birth, address, and phone number. 
    
2. Top left corner: List the UMass Memorial facility from which you're requesting records. If selecting UMass Memorial Medical Group, include the physician’s name.
    
3. Request Type: Indicate if records are for yourself (check "Self") or provide the name and contact information for the recipient.
    
4. Purpose: Check the reason for your request.
    
5. Date(s) of Service: Specify the dates you need records from.
    
6. Specific Services: Mark the types of documents you need. For images or recordings, specify in the “Other” section.
    
7. State/Federal Law: If relevant, check any boxes indicating specific types of sensitive information.
    
8. Delivery Method: Choose to receive records via mail, email, MyChart (if active), or fax.
    Note: Records over 100 pages will be on a password-protected CD.
    
9. Fee: A fee may apply, especially for printed copies.
    
10. Signature: Sign and date the form.
     

Send Completed Forms to:

Email: medctrmr@umassmemorial.org
Fax: 508-334-9717
Mail:
UMass Memorial Health
c/o HIM Department
67 Millbrook Street, Suite 200
Worcester, MA 01606 

Health care proxy agents:  

If you are requesting records as a HCP agent, the health care proxy must be invoked by a provider and must be made for continuing care purposes.

Deceased patients’ medical records:  

If you are requesting an autopsy or medical records of a deceased patient, you must submit an authorization along with one of the legal documents obtained through the Probate Court:

• Court appointment as Executor of Estate/ Letter of Authority for Personal Representative
• Court Appointment as Voluntary Administrator/ Attested copy of Voluntary Administration Statement
   

Milford Regional Medical Records: 

Visit the Milford Regional Medical Center Medical Records Department or call 508-422-2487.

Billing records: 

Contact our Billing department at 508-334-1840

Radiology images: 

Please follow up with the Radiology department of the facility the services were provided:

• Harrington: 508-765-3030  
• HealthAlliance-Clinton Hospital: 978-466-2689  
• Marlborough Hospital: 508-486-5600
• Milford Regional: 508-422-2487
• Medical Center University Campus: 774-441-8406  
• Medical Center Memorial Campus: 508-334-6131  

A fee for photocopies may apply per Massachusetts General Law, Chapter 111, Section 70.  Upon receipt of a signed Authorization Form, UMass Memorial will process the request within seven to 10 business days and send an invoice for payment of the copies.  Please note:  A request may take up to 30 days if you are requesting records over 10 years old.

If you have any questions, please contact the Health Information Management department directly by phone at 508-334-5700 or email: medicalrecords.medctr@umassmemorial.org.