Medical Records at UPMC Shadyside

To request your record:

1. Download the Authorization for Release of Protected Health Information.
2. Fill out the form. Please type or print neatly. Be sure to complete both Part 1and Part 2. 
3. Sign and date the form.
4. Make a copy for yourself.
5. Send the original to:

   UPMC, Release of Information Department
   450 Melwood Ave - Lower Level
   Pittsburgh, PA. 15213

6. After we receive your request, we will send you an invoice for the cost of the records you requested. You should receive this invoice 7 to 10 days after we receive your request.
7. Send payment as indicated on the invoice.
8. After we receive payment, records will be mailed the next day.

Find additional information about requesting medical records from UPMC in the patients and visitors section of UPMC.com.