Medical Release Authorization

If you would like a copy of your medical records, you must fill out a Medical Release Authorization form.

To obtain a copy of your records download a General Medical Records Release.

The release form must be completely filled out. Failure to complete the form in its entirety may delay the release of your records.

FAX the completed form and a copy of your ID to the Medical Records Department at (855) 874-5286 or email to ppsc.uccbomedicalrecords@parallon.com.

In accordance with The Texas Medical Board Rules, the process time for requests is 15 business days. If you have questions or need assistance completing the form, e-mail questions to ppsc.uccbomedicalrecords@parallon.com.