Request Patient Records and Release of Information

Patient records are confidential by law and are not released to anyone, including parents, spouse, friends, other health professionals, and/or university personnel, without the written consent of the patient. Your medical records are not associated with your academic record.

You can view electronic health information such as your SWC visits and test results by logging into the Student Wellness Center Patient Portal and clicking on the "Medical Records" section on the home page after you are logged in.

Client Records Requests/Release of Information

To obtain a copy of your records and/or to release members of the Student Wellness Center to disclose/discuss information about your care, please complete and return the Authorization for Release of Information/Records form [pdf] in person or fax to 408.924.7786.

The form permits you to state the reason for the release, indicate how broad or narrow of a release you desire & who to disclose the information to (such as another health care professional). Please review 菠菜网lol正规平台’s Subpoena Guidelines, if applicable.

Requesting Itemized Statement of Charges

To obtain an Itemized Statement of augmented health care fees you paid, complete the Itemized Statement Form.