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Record Releasing

What is a medical record?

The medical record is a legal document providing a chronicle of a patient's medical history and care. Physicians, nurse practitioners, nurses and other members of the health care team may make entries in the medical record. Every patient who has received health care services at the Purdue University Student Health Center has a medical record.

Some of the information contained in the medical record is:

  • Identification information such as:
    • Local address
    • Telephone number
  • Patient's health history
    • This is information a patient tells the health care provider about their past and present health status
  • Medical examination findings
    • This is what the health care provider observes when the patient is examined.
  • Other information may include:
    • Lab test results
    • Medications prescribed
    • Referrals ordered to health care providers outside of the Purdue University Student Health Center
    • Educational materials provided
    • Patient instructions

Who has access to my medical records?

Only authorized personnel at the Purdue University Student Health Center have access to the medical records. In most cases, a patient's written authorization must be given in order for the information to be shared, exceptions to this include:

  • Forwarding records to other health care providers for continuity of care
  • Releasing information when required by law, such as the reporting of infectious disease or animal bites to the state health authorities.

If you would like another person, such as a parent or spouse, to be able to communicate to PUSH staff regarding your healthcare, please follow the instructions in Option 2 of How to Request a Copy of My Medical Record and designate that person as a recipient.

How long do you retain my medical record?

Medical records of Purdue students are kept 7 years following the last date of service. After 7 years of inactivity, the medical records are securely destroyed in accordance with state and federal regulations.

How do I request a copy of or authorize access to my medical record?

Option 1
You may request a copy of your medical record for yourself or another health care provider by coming to the Health Information Management department at the Purdue University Student Health Center on the main floor, Room 137. You will need to show a photo ID and sign an authorization to release your record.

Option 2
For those who cannot make a personal visit to the health center, please submit the Purdue HIPAA Authorization to Use or Disclose to:

Health Information Management
Purdue University Student Health Center
601 Stadium Mall Drive
West Lafayette, IN 47907
Fax#: 765.496.1907
Phone#: 765.494.1838

Request should include

  • Full legal name and Student Identification Number or date of birth. (Include your name while enrolled at Purdue University if different)
  • What part of record you want (be specific: per date(s); type of problem) and the purpose for the release.
  • List the complete address for where to send records and telephone number. If records are to be faxed, please include the fax number.
  • Include your phone number and a billing address.
  • Sign (written signature) and date to validate.

We regret that we cannot accept requests for copies of medical record information by e-mail.

Immunization Record Releasing

For Immunization Recordkeeping please fax the form to 765.494.1836

Are there charges for copies of my medical records?

If you are requesting a copy of your medical records for another health care provider there is no charge. If you are requesting records for other purposes, a copying charge of $5.00-$15.00 may be incurred. This fee must be paid when copies are picked up, as this can not be billed to you.

How may I contact someone regarding these services?

You may call the Health Information Management department at 765.494.1838, Monday-Friday, 7:30 a.m.-4:30 p.m.

How long does it take to get a copy of my medical record?

Medical records requests for information from patient’s records will be processed in a timely, consistent manner as follows:

  • Emergency care of patients: immediate processing
  • Urgent patient care: 1 – 2 working days
  • Moderate patient care: 3 – 5 working days
  • Patient request to view or copy own record: 5 – 10 working days
  • Subpoenas, court orders, depositions: within 14 days
  • All other requests: within 14 days

If you have trouble accessing this page because of a disability,
please contact PUSH

Purdue University Student Health Center, 601 Stadium Mall Dr, West Lafayette, IN 47907, (765) 494-1700
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