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Health Information Management

Contact Information

PUSH - Room 140
601 Stadium Mall Drive
West Lafayette, IN 47907
Fax: 765-496-1907

Release of Records Phone: 765-494-1838

Immunization Information Phone: 765-494-1837

Health Information Management (HIM) at PUSH is responsible for a variety of functions that include:

  • Release of Information
  • Amendment to Patient Records

Release of Information

Medical records are kept for 7 years, and may be retrieved through the HIM department. To obtain medical records, a valid authorization must be completed and signed by the patient if over 18, or parent/guardian if under 18. HIM will process the request and provide records to the authorized party within 30 days.

Current students wishing to allow others access to their medical records may submit a completed authorization form or locate an electronic form on the homepage of the patient portal. Patient without access to the Patient Portal may obtain their records by completing the authorization form or they may contact HIM at 765-494-1838 to obtain an electronic authorization form.”

Sample Authorization Form

Authorization Form

Advance Directive

Advance Directive is a term that refers to your spoken and written instructions about your future medical care and treatment. By stating your health care choices in an advance directive, you help your family and physician understand your wishes about your medical care. An advance directive may name a person of your choice to make health care decisions for you when you cannot make the choices yourself. Your advance directive will only be used when you are unable to communicate or your physician decides that you no longer have the mental competence to make your own choices. If you have an advance directive, please provide a copy to PUSH Health Information Management. 

A Living Will and a Durable Power of Attorney for Healthcare are two common types of Advance Directives.

A Living Will provides instructions to physicians and family members regarding the individual's desires for treatment. This is most often used to determine whether or not an individual wishes to be on life support or resuscitated.

A Durable Power of Attorney specifies who the student would like to make healthcare decisions for them in the event that they are unable to make decisions on their own.

When should you obtain an Advance Directive?

Adult students who would like someone other than their next of kin (parent, spouse, adult child) to make healthcare decisions on their behalf or those that have specific requests regarding treatment such as life support or resuscitation desires should consider obtaining and submitting an Advance Directive. In Indiana, the next of kin will make health care decisions if an Advance Directive indicating otherwise is not on file. No Advance Directive is required if the next of kin will be making decisions.

More information and assistance regarding these documents can be found on the Purdue Student Legal Services web page.

Amendment to the Patient Record

If you believe that there is a mistake in your health information or that a piece of important information is missing, you have the right to request that we amend the existing information. You must provide the request and your reason for the request in writing to the HIPAA liaison at the location listed at the top of this notice. We may deny your request in writing if the health information is: 1) correct and complete; 2) not created by us; 3) not allowed to be disclosed, or 4) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you do not file a statement of disagreement, you have the right to ask that your request and our denial be attached to all future disclosures of your health information. If we approve your request, we will make the change to your health information, tell you that we have done it, and share the updated record with those that have previously received this information.

Amendment Request Form