Medical Records Requests

Requesting Copies of Your Medical Records

Because your medical information is confidential and requires a high level of security, a written request with your signature is required prior to releasing copies of medical records. Requests for copies of medical or mental health information are completed within 7-10 working days upon receipt of a valid, signed release form. There is no charge for copies of medical records for continuity of health care.

All medical records of patients seen at The Student Health and Wellness Center are retained for 11 years after the last patient visit. After 11 years of inactivity, medical records are confidentially destroyed.

Medical Record Release Forms

Directions for Completing the Medical Record Release Forms

  1. Download the appropriate release form (medical or
    mental health) and print it out on any printer.
  2. Complete the release form in its entirety. Sign and date the bottom of the form. If you have any
    questions on how to fill out the release form please call Medical Records Services at (414) 229-4716.

    *NOTE: If any portion of the form is incomplete, it will be returned to the requestor and cause delay in processing.

  3. Mail the authorization form to:
    Medical Records/The Student Health and Wellness Center
    University of WI-Milwaukee
    PO Box 413
    Milwaukee, WI 53201-0413
    Or fax the form to: 414-229-4161