Follow the steps to successfully complete the Uofl Medical Records Request online.

1. Press the ‘Get Form’ button to access the medical records request form and open it for editing.
2. Fill in the section titled 'Release Records to' by providing the name, phone number, and fax number of the person or provider you wish to release your records to.
3. Include the complete address of the designee in the provided fields, which consists of the street, city, state, and zip code.
4. If you are requesting records from another provider to be sent to UofL Physicians, fill out the corresponding section with the provider's information, including their name, phone number, fax number, and address.
5. In the 'Patient Information' section, clearly print the patient's name and date of birth.
6. Have the patient, parent, or legal guardian sign the form in the designated signature area and include the date of signature.
7. If the signer is a parent or legal guardian, they should print their name below their signature.
8. Specify the records being released by indicating a date range or selecting options such as 'Entire Chart,' 'Labs,' or 'Office Notes.' If needed, specify any other records in the designated space.
9. Review all entered information for accuracy before submitting the form, ensuring all necessary signatures are obtained.
10. Once completed, you can save changes, download, print, or share the form as needed.

Complete your Uofl Medical Records Request online today to access your important health information.