Medical Records and Health Information - Student Health Center

The Student Health Center retains patient medical records for a minimum of 10 years from the date of last visit. Active records are on file at the Student Health Center for a minimum of 2 years. Records of patients whose most recent visit is more than 2 years from the current year are maintained in our off-site storage facility.

Requesting Copies of Medical Records

Requests for copies of medical records must be in writing and should be made in advance of the time or date on which you need them. A reasonable, cost-based fee may apply. Applicable fees must be paid in advance before records are released.

To obtain a copy of your medical record for yourself, download, print, complete and sign the following request form and return it to the Student Health Center in person, by fax or by mail: Request for Access to Medical Record
To request a copy of your medical record to be sent to a third party, such as another healthcare provider, attorney, or insurance company, download, print, complete and sign the following authorization form and return it to the Student Health Center in person, by fax or by mail: Authorization for Release of Health Information
Release of HIV test results must be authorized separately from authorization for release of other medical records. To authorize the release of HIV test results, download, print, complete and sign the following authorization form and return it to the Student Health Center in person, by fax or my mail: Authorization for Disclosure of HIV Test Results

Please note: Student Health Center policy, in accordance with CDC guidelines, is that all HIV test results are given to the recipient in person before the records may be released via phone, mail, or fax.

If a lab or x-ray is ordered by an outside physician and the test is performed at Student Health, the results are sent immediately to the ordering physician. All requests for the results should be made to the ordering physician’s office.

Charges for Medical Record Services

Copies of medical records will be sent to another healthcare provider free of charge.
There is no charge for copies of selected reports. (A $20 retrieval fee may still apply for archived records.) Those reports, when requested singly, include:

Immunization record
Physical examination record
Laboratory report
X-ray report

A fee of $30 will be charged for the copying and handling of medical records, in whole or in part, when those records are released to any entity other than a healthcare provider.
A fee of $20 will be charged for retrieval of inactive records from off-site storage (+$30 for the copying and handling of records). The retrieval fee for inactive records must be paid in advance before the record will be requested from our off-site storage facility.
Next day retrieval or rush requests will be assessed at a higher rate .
Payment for medical records services must be made in person at Student Health Center or by check, mailed with your request. We cannot accept payment over the phone.

Confidentiality

All patient information is confidential and protected by privacy laws. Information from your records will not be released to anyone without your written authorization, except as required by law. Our Notice of Privacy Practices describes how medical information about you may be used and your rights as a patient.

Additional Information

For more information, please review the Medical Records section of the FAQs.

For help in completing Medical Record/Health Information authorization forms or any other questions, please contact the Medical Correspondence Desk at (949) 824-9634.