Medical Records Requests
Medical records are confidential documents that contain a patient’s protected health information, treatment details, and diagnostic information, which can be requested for personal, legal, or medical use.
Requesting Medical Records from United Regional
To request your medical records from United Regional, complete the Authorization to Disclose Protected Health Information form. This form must include your personal details, the recipient’s information, the reason for disclosure, and the specific records you wish to access. Initials are required to release sensitive information such as mental health, substance abuse, or HIV/AIDS records.
Once completed, submit the Authorization to Disclose PHI form in one of the following ways:
- In person: Drop off your form at the front desk in Bridwell tower, located at 1600 11th Street, Wichita Falls, TX 76301.
- By mail or fax: Use the contact details listed in the authorization form. Fax submissions should be sent to 940-764-3355.
Medical records will be mailed to you or made available for pickup.
Need Help?
For questions about requesting medical records or completing the authorization form, contact the Medical Records Department at 940-764-3627, Monday through Friday, 8 a.m. to 4:30 p.m.
Release of Information Requester Portal
Third party requesters—such as attorneys, researchers and health plans—can now request, pay for and access medical records through our online Release of Information Requester Portal.
This secure portal streamlines the release process by reducing or eliminating faxed authorization forms, mailed payments and printed deliveries—helping requests move faster from submission to fulfillment.
- With the Requester Portal, third party users can:
- Enter and manage requester profile information
- Download your organization’s release authorization forms
- Upload completed authorization forms and supporting documents, such as photo IDs
- Submit release requests by entering patient and request details
- Pay for and securely download released records
Important: A PDF file viewer, such as Adobe Reader, is required to view downloaded files.
Note: This portal is not available to patients requesting their own medical records.