How To Request Medical Records:
If you would like to receive a copy of your medical records, please complete the Release of Information authorization form below and return it to Tulane Doctors by email, fax or in person with a copy of a valid photo ID.
E-mail Request for Medical Records:
Complete the Release of Information authorization form. E-mail completed form and copy of valid photo ID to: firstname.lastname@example.org
* If you choose to return this form by email, please be aware that communications via email over the internet are not secure. E-mails can be intercepted during transmission, and that unencrypted messages (and any attachments) can be read, and potentially copied and forwarded, by anyone. Unencrypted emails can also be easily viewed by someone other than the recipient. By sending this form by un-secure email, you are agreeing to communicate using an unsecured email platform and assuming all such associated risks.
Fax Request for Medical Records:
Complete the Release of Information authorization form. Fax completed form and copy of valid photo ID to: 505-988-0889; Attention: TUMG Release of Information
In Person Request for Medical Records:
Please contact the clinic location where you have received medical treatment. The clinic staff will be able to accommodate your request for medical records. Please remember to bring a valid photo ID.
- Release of Authorization PHI Form (English)
- Release of Authorization PHI Form (Spanish)
- Release of Authorization PHI Form (Vietnamese)