The Health Information Management Department
(HIM) at UTMB is dedicated to maintaining your medical records and
keeping your health information private and secure in accordance with
federal and state regulations.
Release of Information
- For copies of a medical record please contact:
- The University of Texas Medical Branch
- Department of Health Information Management
- Release of Information Section
- 301 University Blvd.
- Galveston, Texas 77555-0782
For after-hours/weekend information, contact the HIM Request Center at 409.772.2400.
Located on the 3rd floor of the McCullough Building Room 3.300.
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.
versions of this form are available.
(for printing 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
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
A current fee schedule for disclosure of health care information is available on the UTMB Health Information Management Web Site.
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 More Information:
For further information about the release of medical
information, contact the UTMB Health Information Management Department
at (409) 772-1965.