How to Request Medical Records
If you are using the internet, please download, print, complete, and sign the following forms, then fax or mail them back to us with the attention to Medical Records Department. Please be sure to sign the forms. Unsigned requests cannot be processed. Please include a copy of your photo I.D. and a phone number.
Your request will be processed and fulfilled within ten working days. We will either mail your copy to the address specified on the authorization form, or you may pick up your records from our offices located in the Western Maryland Office Complex (third floor) between the hours of 8 a.m. to 4 p.m., Monday through Friday. All other times need to be pre-arranged with the department.
There is 76¢ per page copying fee. We will let you know by mail or telephone how much the total charge will be once we retrieve your records from our archives. You may pay the charge by mail (to the address above) or in person if you wish to pick up your copy.
Should you wish to contact the Medical Records Department, you may call 240-964-8441.
- Authorization for Use or Disclosure of Health Information
- Request for an Accounting of Disclosures of Health Information
- Request for Special Restriction on Use or Disclosure of Protected Health Information
- Request to Amend Protected Health Information
Frequently Asked Questions
How may I request a copy of my medical records?
Download, print, complete and sign the Authorization for Use or Disclosure of Health Information and return it via fax (240-964-8447) or mail to UPMC Western Maryland with attention to Medical Records Department. Please include a copy of your photo I.D. and a phone number. You may also request an authorization by calling Medical Records at 240-964-8441. Please note that unsigned requests will not be processed.
May my spouse request and receive copies of my medical record?
No. Another person may not receive copies of your medical record without consent from authorizing the Medical Center to release copies to him or her.
What are your hours of operation?
We are open from 8 a.m. to 4 p.m. EST, Monday through Friday and closed on national holidays. Arrangements can be made to pick up records outside of these hours for special circumstances.
When may I expect to receive my copy?
Because of the large number of requests we receive daily, it may take up to 10 working days to fulfill your request.
Will you fax the copies to my home or office?
No. We cannot fax medical records due to confidentiality issues.
Will you mail the copies or will I have to pick them up?
We can mail the copies to the address you specify on the authorization form, or you may pick them up during our hours of operation.
How long do you keep medical records?
Adult medical records are kept for 10 years. The records of patients who were 18 years or less at the time of treatment are kept until the age of 28. Female (new moms) delivery medical records are also kept until the child reaches the age of 28 years.
How may I request copies of records from my last doctor visit?
Contact your physician’s office for assistance. We do not keep private physician office medical records.
Can you explain the charges on my bill?
No. Please contact our Billing Office at 240-964-8384.
How do I obtain a copy of my lab work?
All other Lab work results may be picked up at the Medical Records office located on the third floor of the Willowbrook Office Complex. Please call ahead for pickup and the staff will call you when available.
May I obtain a copy of my x-ray films from you?
No. Please contact Radiology at 240-964-1111.
How do I request a copy of my birth certificate?
Western Maryland Regional Medical Center does not keep birth certificates for those patients born here. You may request a copy through the local Allegany County Health Department by calling 301-759-5002 or from Division of Vital Records in Baltimore, MD., by calling 410-764-3038.
Chesapeake Regional Information System
UPMC Western Maryland participates in the Chesapeake Regional Information System for our Patients (CRISP), a regional health information exchange serving Maryland and the District of Columbia. A Health Information Exchange, or HIE, is a way of electronically sharing health information among hospitals, doctors’ offices, labs, and other health organizations. HIE allows delivery of the right health information to the right place at the right time., providing safer, more timely and efficient patient-centered care.
We encourage you to learn about CRISP and how it facilitates your care. Patients can choose not to participate in CRISP and information about how to opt-out is available at www.crisphealth.org
Location & Contact
Medical Records Department
UPMC Western Maryland
12500 Willowbrook Road, SE, PO Box 539
Cumberland, Maryland 21502
Hours of Operation
Monday – Friday 8:00 a.m. – 4:00 p.m.
Saturday – Sunday Closed