Requesting Your Medical Records from UPMC St. Margaret

To request your medical records from UPMC St. Margaret:

1. Download the Authorization for the Release of Protected Health Information Form (PDF).
2. Fill out the form. Be sure to complete both parts 1 and 2.
• For help completing the form, review the completion guide (PDF).
3. Sign and date the form.
4. Make a copy for yourself.
5. Mail, drop off, or email the original authorization form to UPMC.

Mail the form to:

UPMC, Release of Information Department
450 Melwood Avenue – Lower Level
Pittsburgh, PA 15213

Scan the form and email it to ROIRequest@upmc.edu.

After We Receive Your Request for Medical Records

• After we receive your authorization form, we will send you an invoice for the cost of your records. You should get this invoice within 7 and 10 days from when we received your request.
• Send payment as indicated on the invoice.
• After we receive payment, we will mail your records the next day.