To request a copy of a medical record:

For Patients

To request a copy of a medical record, you will need to complete and sign an Authorization to Disclose Medical Information form.

Download Authorization to Disclose Medical Information Form

How to Complete Authorization to Disclose Medical Information Form

The completed form can be emailed to HIMrequests@drexel.edu, faxed to 215.255.7305 or mailed to:

Drexel Medicine Health Information Management Department
New College Building
245 North 15th Street, 6th Floor Suite 6122
Philadelphia, PA 19102

**If you need a paper copy of the form, call the HIM staff at 215.255.7321 and one will be mailed to you.

For Providers

For providers, hospitals and other health care facilities the Drexel Medicine Health Information Management (HIM) Department fulfills requests for continuation of care as our priority. For urgent and/or time-sensitive requests, please call the HIM staff at 215.255.7321.

For routine continuation-of-care requests email HIMrequests@drexel.edu or fax to 215.255.7305.

For All Other Organizations

For requests from other agencies such as law firms, insurance companies, or agencies, in addition to the current required authorizations, Drexel University will require an attestation to be completed as mandated in the HIPAA Privacy Final Rule to support Reproductive Health PHI (Protected Health Information) privacy and use.

Download Attestation for Requested Use of Reproductive Health Care PHI

Letter for Requested Use or Disclosure of PHI Related to Reproductive Health Care

Email the attestation and all appropriate legal documentation to HIMrequests@drexel.edu, fax to 215.255.7305, or mail to:
Drexel Medicine Health Information Management Department
New College Building
245 North 15th Street, 6th Floor Suite 6122
Philadelphia, PA 19102

You will be sent an invoice for these services. Payment can be made by check, payable to Drexel Medicine – HIM Department, and mailed to:

Drexel Medicine Health Information Management Department
New College Building
245 North 15th, Street 6th Floor Suite 6122
Philadelphia, PA 19102

Or pay securely by credit card at secure.touchnet.com.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

 
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