Copies of records can only be released to the patient, his/her duly assigned representative, or healthcare provider. Proper authorization is required.

To request a copy of your medical records, click and print the authorization form, complete the form, sign and date it. 

Fax completed form to 609.497.4993 or mail to:  HIM Department, University Medical Center at Princeton, 253 Witherspoon Street, Princeton, NJ 08540.

If you have any questions, call us at 609.497.4270 or e-mail us at recordrequest@princetonhcs.org. For confidentiality reasons, we do not recommend that you e-mail us your authorization form.

Copy Charges for Medical Record Requests

Requests for chart abstracts will be charged at a rate of $1 per page. Chart abstracts include the following documents (as applicable):

• Face sheet
• History and physical report
• All consultations
• All operative reports
• Discharge summary or note
• First 48 hours and last 24 hours of laboratory values (greater than 30 days)
• All radiology examination reports (greater than 30 days)
• All diagnostic cardiopulmonary examination reports

For all other requests, a "per page" rate of $1 per page up to 100 pages and 25 cents per page thereafter (not to exceed a total charge of $200 per admission) will be charged.

Type of Payment Accepted

Payment may be made by cash, check, credit card and money order. Payment is due in full prior to receipt of the copied records.

All forms of payment will be accepted by the UMCP Cashier between the business hours of 7:30 a.m. and 4 p.m. Between 4 p.m. and 9 p.m., the Health Information Management staff will accept checks and money orders only.

Credit card payments also can be made directly at any time via a dedicated hotline, 1.800.367.1500. (Select option 1 to make a payment.)

For more information, contact the Health Information Management Department at 609.497.4270 or e-mail us at recordrequest@princetonhcs.org.