The UTMB Health Information Management (HIM) Department is committed to respecting and protecting the rights of our patients and their families. Our team is responsible for maintaining the confidentiality of all patient records and to assist you with your medical record requests.
Medical records are protected health information that cannot be released to any person or organization without the consent of the patient or the patient’s legally authorized representative (unless authorized or required by law).
Please note the HIM staff cannot interpret what the information means or discuss it with you.
How to obtain your records
UTMB provides access for patients to significant portions of their medical record—including test and lab results, immunization history, after visit summaries and notes, provider messaging and more—through a patient web portal called UTMB MyChart.
Sign up or learn more about MyChart
For medical records not available in MyChart:
ONLINE Medical Record Request
UTMB has contracted with a partner (Ciox Health) to offer an efficient and convenient process for requesting the release of medical records online. Medical records may be requested via a secure website hosted by Ciox. Select the button below to
ONLINE Medical Record Request
IN PERSON/VIA MAIL Medical Record Request
If you are unable to complete your records request online, records may also be requested by visiting the Health Information Department to fill out an authorization, or mailing/faxing an authorization and request to the HIM Office.
Written Authorization: Requests for the release of medical records must be submitted in writing (or via the online process outlined above) 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.
Authorization forms can be downloaded from the links below:
- For patients/parent or guardian needing records, please submit the following form: English or Spanish (forms 7033/7033SP)
- For all other requests for records please submit the following form: English or Spanish (forms 7032/7032SP)
These documents are designed to be printed and are offered in Adobe Portable Document Format (PDF). 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.
Submitting An Authorization
For UTMB patients requesting records (those not using the online Ciox application), please fax your request to (409) 772-9208 or mail it to the “HIM – Release of Information”
address listed below.
For healthcare facilities requesting records:
If the patient is in office, has an upcoming appointment or the records are needed for review please indicate this on the request. Please fax your request to (409) 772-5101.
For all other requesters, please mail your request to:
University of Texas Medical Branch
HIM - Release of Information
301 University Blvd.
Galveston, TX 77555-0782
Once written consent has been completed, medical records can be obtained onsite from the following location:
Jennie Sealy Hospital
712 Texas Avenue
Room 2.202 (next to PJ’s Coffee)
Galveston, TX 77555
Please allow up to 15 days for the information to be assembled.
A current fee schedule for release of health care information is
available online. Additional information is on the UTMB Health Information Management website.
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.
The UTMB Health Department of Radiology is responsible for managing the release of diagnostic images to patients and authorized care providers for all forms of radiology. To learn more or make an online request, visit Radiology and Imaging.
For More Information
For additional information or assistance related to medical records and release of personal health information at UTMB Health, please call (409) 772-1965.