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Medical Record Request

Location: Room 1500, first floor of University Hospital
Phone: 315 464-7832
Hours: Monday-Friday, 8 am–4:30 pm

The Release of Information Department processes all types of requests for copies of the patient's health information. Physicians and the public can call with requests and questions on how to obtain copies of medical records, or they may come and request copies of their medical records directly.

Request a Copy of Your Medical Record

By Mail:

  • Download the Authorization form
  • Complete the form and mail it to:

    Health Information Management/
    Clinical Data Services–Release of Information Services
    Upstate Medical University
    Room 1500 Hospital
    750 East Adams Street
    Syracuse, NY 13210


    HIM/Release of Information Services
    Upstate Medical University at Community Campus
    4900 Broad Road
    Room 1372
    Syracuse, NY 13215

  • or Fax to:  315-464-9555
  • or Email to:  [email protected]

If you have problems accessing the form, call 315 464-7832 (downtown) or 315 492-5565 (community)

In Person:

If you would like to request a copy of your medical record in person, the Release of Patient Information Services is located in room 1500 on the first floor of University Hospital. The office is open from 8 am to 4:30 pm Monday through Friday.

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