Release of Information

The information contained in the patient's medical record is confidential. All requests for release of medical records must include an authorization form signed by the patient. The form must have an original signature, not an electronic signature.

Follow these steps for submitting a request for your medical records. If you have any questions, please contact us at 410-328-6750. We are open 7 days a week, 24 hours a day for general information.

STEP 1: Authorization Release Forms

•    Print the authorization form.*


STEP 2: Submit Request (Authorization Release Form)

Please mail, fax or deliver in person your authorization release form.

  • In Person
    Department of Health Information Management
    22 S. Greene Street
    Baltimore, Maryland 21201
  • By Mail
    HIM/Medical Records
    Attn: ROI
    110 S. Paca Street, 9th Floor
    Baltimore, Maryland 21201
  • By Fax
    Fax services are available Monday – Friday, 8:00 am-4:30 pm
    For emergency patient care only, fax to 410-328-2358
    For all other requests, fax to 410-328-0537
    After normal business hours, please call 410-328-6750 before faxing a request.

STEP 3: Receive Invoice

Fees: Patients

You will be billed the following for copies of medical records you requested:

  • Electronic copy: $7.00
  • Paper Copy: $0.07 per page + postage
  • Return all invoices (with the remittance portion of the invoice) and make checks payable to University of Maryland Medical Center. Send to the HIM address listed below.

Fees: Third-Party Payers

Payment is required before medical record information is released. You will be charged:

  • Base charge (to cover supplies and labor): $22.80
  • + Per page fee: $0.76 per page
  • + Postage

Mail to:

  • HIM/Medical Records
    110 S. Paca Street, 9th Floor
    Baltimore, Maryland 21201
     

STEP 4: Receive Records

You should receive your records within 5 days of receipt of your payment. If you do not receive your records within 10 days, please call 410-328-5706 and select Option 2 to reach an ROI (Release of Information) technician.

If you receive a Customer Service Card with your record, please return this prepaid postcard to us with your comments. We strive to provide excellence to all our customers.

*NOTE: Download a free version of Adobe Acrobat Reader, which is required to print the form.