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How to request a copy of your medical records

The Medical Records Department of Unity Physicians Hospital releases medical record information in accordance with established procedures consistent with federal and state law.

Here’s how to get a copy of your hospital medical records:

  1. Access your patient portal to send a request
  2. Call Unity Physicians Hospital and ask for the Medical Records Department, (574) 231-6834
  3. Mail a completed Release of Information Authorization form
  4. Fax a completed Release of Authorization form to (574) 231-6165

Download our Release of Information Authorization form.

Please allow up to 7 days for processing.

To pick up your medical records in person, you must have:

  • Photo ID
  • Completed/signed Release of Authorization form

Medical records for patients of former UMSH clinics

If you were a patient of ISPINE, Unity Family Practice and Unity Family Medicine, you can request to have your clinic records transferred to your physician or yourself.

Here’s how to request a transfer of records:

  • Complete the Release of Information Authorization form (ISPINE, Ortho & Sports Care and Unity Family Medicine)
  • List the clinic where you were a patient
  • Fax a completed Release of Authorization form to (574) 231-6165 OR fax the completed Release of Authorization form to ScanSTAT, our Medical Records storage partner, (267) 845-2105
  • Mail a completed Release of Authorization form to the Medical Records Department
  • Call ScanSTAT Customer Service, (215) 774-1291 for more information

Contact us

Unity Physicians Hospital
Attn: Medical Records
4455 Edison Lakes Parkway
Mishawaka, IN 46545

Hours of operation: 8:00 a.m. – 5:00 p.m. Monday-Friday

Secure Fax: (574) 231-6165
(574) 231-6800

Download our Release of Information Authorization form.