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Request Your Records

About Request Your Records

Records Request

You can request copies of your health records on file with University Health Services by completing the UHS Request for Records form and a Signed Consent to Release Records form. The request form and the consent (if applicable) can be e-mailed to the office at jeffuhs@jeffersonhospital.org or faxed to 215-923-5778.

Please allow two business days for your request to be processed. You can pick up your records after 2 p.m. on the second business day. Please be sure to bring a valid Jefferson or government-issued photo ID in order to retrieve your copies.

Form Request

Our staff will complete forms required for your clinical or affiliate rotations. Please bring the form and all associated instructions with you when you drop the form off. The fee is $5 per form and must be paid at the time of your request. UHS accepts cash and check. Unfortunately, credit cards are not accepted.

Please allow two business days for your form to be completed. You can pick up your form and records after 2 p.m. on the second business day. Please be sure to bring a valid Jefferson or government-issued photo ID in order to retrieve your copies.