Medical Record Requests
Campus Health is a HIPAA-covered entity with a commitment to the privacy and confidentiality of our patients' health information and records.
To request a release of your personal healthcare records (from the Health Center) or counseling services records (from the Counseling Center) to another healthcare provider, entity, or to yourself, you must fill out this form:
Complete the form, then either mail, fax, or email your request:
- Mailing address: Tulane University, 6823 St. Charles Ave., Bldg. 92, New Orleans, LA 70118 Attn: Medical Records
- Fax: 504-865-5083
- Email: CHMedRecords@tulane.edu (Please note: Mail or fax is a more secure method to submit your request.)
Who is authorized to sign for the release of information to obtain a copy of the medical record?
The following individuals may sign the authorization for release of medical information:
- The student/patient
- An individual with authorized power of attorney if the student/patient is not able to sign (documentation must be provided).
Please note: A spouse or domestic partner may not request medical records without the student/patient's consent.
Tulane University Campus Health does not review or retain documents submitted in advance of your student establishing a treatment relationship with Campus Health. In the event of emergency/life threatening situations, notification does not require documentation such as an authorization form or power of attorney to be on file.
How much does it cost to obtain a copy of my medical record?
There is no charge for releasing medical records to enrolled students or former students. There may be a fee associated with requests from legal or insurance entities.
When will I receive a copy of my medical record?
Your request will be processed within five business days. If you need your records more urgently, please call the medical records office.
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