Request Medical Records

Spotlight/Common Content: COVID-19 Release of Information office closing

The Michigan Medicine Release of Information office is currently closed to walk-in services.  If you have a MyUofMHealth Patient Portal account, you can submit requests for copies of medical records from the portal by using the Medical Record Request form listed under the My Record section.

If you have an urgent need to get copies of your medical records, please call the Release of Information Unit at 734-936-5490 Monday through Friday from 8am – 5pm or fax your request to 734-936-8571.

If you do not have a portal account, follow this link for instructions on how to create a MyUofMHealth Patient Portal account.  If you need assistance with account recovery or setting up your portal account, you can call the MyUofMHealth Patient Portal Help Desk at 734-615-0872. 

MyUofMHealth Patient Portal Help Desk 

Phone number for patients and staff: 734-615-0872

The Help Desk is available Monday through Friday 7am – 7pm and Saturday 8am – 1pm.

 

Obtaining Copies of Your Medical Records
Release of Information (ROI)

Records can be released to anyone that the patient authorizes (in writing). A valid authorization MUST contain the following information or the request will be returned:

  • Patient's full name and date of birth (list any other names the patient may have had
  • Medical Registration Number (MRN) (if available)
  • Specific information being requested (e.g., type of report/information and dates of service, etc.)
  • Purpose for which the information may be disclosed
  • To whom the information is to be sent (name and address)
  • Specify authorization's expiration date if desired (see ROI form)
  • The patient's signature or a patient's legal representative's signature. Authorizations signed by a representative must contain a copy of the guardianship papers or power of attorney
  • Date of the signature.

Authorization to Release Copies of a Medical Record

Authorization to Release Copies of a Medical Record - SPANISH

PDF icon Authorization to Release Copies of a Medical Record - CHINESE 

PDF icon Authorization to Release Copies of a Medical Record - JAPANESE

PDF icon Authorization to Release Copies of a Medical Record - ARABIC

Patient Authorization Revocation

Authorization for the Release/Disclosure of Substance Use Disorder Information

Requests for medical records of deceased patients require a letter of authority in addition to your signed request. The letter of authority is given to the executor of a person's estate by the Probate Court upon their death. Releasing records to anyone other than the executor is illegal, as stated in Michigan Court Law 600.2157. Please also include your phone number in case we need to contact you for additional information concerning your request.

Revenue Cycle Mid Service (HIM)
Release of Information (ROI) Unit
3621 S. Street 700 KMS Place
Bay 11 – Mid Service
Ann Arbor, Michigan 48108-1633
Phone: (734) 936-5490
Fax: (734) 936-8571