All patient health care information at UTMB is confidential. Therefore, medical records cannot be released to any person or organization without the consent of the patient or the patient’s legally authorized representative (unless authorized by law).
Requests for the release of medical records (protected health information) must be submitted in writing and must contain all the elements required by law. Authorizations must also be dated and signed by the patient or the patient’s legally authorized representative. In the case of a minor, a parent or legal guardian must sign the authorization.
UTMB has an authorization form that can be downloaded.
If you do not have the software to view and print this type of document, you can download the plug-in for free from the Adobe Web Site.
Or you may contact the Health Information Management (HIM) Department at (409) 772-1965 and HIM will email or fax the authorization form to you.
Completed authorization forms may be submitted to UTMB by mail or fax.
University of Texas Medical Branch
Release of Information
301 University Blvd.
Galveston, TX 77555-0782
No fee is assessed when the information is being sent to another health care provider or is for a social security disability claim. Requests for medical record information for social security disability claims must be accompanied by a supporting letter from the Social Security Administration.
For further information about the release of medical information, contact the UTMB Health Information Management Department at (409) 772-1965.
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