Instructions for Requesting Medical Records

To request your medical records, fill out the Authorization for the Disclosure of Protected Health Information form. 

Download the form in your preferred language: 

English  |  Español  |  Português  |  Shqip  |  Tiếng Việt  |  العربية 

 

You can also pick up the form at these locations:

  • University Campus, 55 Lake Avenue North, Worcester
  • HealthAlliance-Clinton Campus, 60 Hospital Road, Leominster

To avoid delays in the process of the release:

  • Fill out the form completely
  • Use clear handwriting

Once signed and completed, you can fax or email the authorization back to us. 

  • By fax: 508-334-9717
  • By email: MedC...

Caregiver Recognition and Awards

Every day, our caregivers go above and beyond for patients, families, and one another. At UMass Memorial Health, we firmly believe in celebrating the unsung heroes who consistently demonstrate exceptional dedication, clinical excellence, compassion, and innovation in their roles. Our awards program is more than just a recognition — it's a tribute to the individuals and teams who go above and beyond to ensure the well-being, safety and satisfaction of our patients, families, and colleagues. If you’ve experienced outstanding care, we invite you to recognize a caregiver who made a difference. 

If...