Alert

Medical Records and Privacy

My UNC Chart

My UNC Chart is a secure online patient portal that allows UNC Health Care patients to see portions of their electronic medical record as they receive care from UNC Providers. Patients can request an account at myuncchart.org to gain access to selected test results, appointment information and summaries of clinic visits and hospital admissions at no charge.

Additional medical records can be requested from Health Information Management.

How to Make Certain Requests Regarding your Medical Record

You may make the following requests to us concerning your protected health information (PHI), but must do so in writing. The best way to make your written request is to click on each request you want to make below, which will allow you to access our form. You may also call us at 984-974-3226 to request that we provide you with a copy of the forms you need to make your requests. You should then complete, sign, and submit your request form(s) to us in any of the following ways:

1. Fill in your Authorization form. (HIM #710-s).

The authorization form can be obtained from any UNC Hospitals, UNC Hillsborough Campus or Chatham Hospital, or you can download a copy from the link

DOWNLOAD AUTHORIZATION FORM (PDF)

2. Sign and return your completed form via:

  • E-mail

Simply scan and attach your completed Authorization Form to:
relmedinfo@unchealth.unc.edu

  • Fax

Fax your completed Authorization Form to: 984-974-0471

  • Mail

Please send your completed Authorization Form to:
UNC HEALTH INFORMATION MANAGEMENT
ATTN: RELEASE OF INFORMATION
500 Eastowne Drive
Chapel Hill, NC 27514

  • Drop-Off

Simply hand in your completed Authorization Form at one of our 5 locations:

  1. 1st floor Eastowne -Visitors Entrance
    500 Eastowne Drive
    Chapel Hill, NC 27514

  2. 1st Floor -UNC Memorial Hospital
    Room #N1215
    101 Manning Drive
    Chapel Hill, NC 27514

  3. UNC Hillsborough Campus
    430 Waterstone Drive
    Hillsborough NC 27278

  4. UNC Chatham Hospital
    475 Progress Blvd.
    Siler City NC 27344

  5. UNC Wakebrook
    107 Sunnybrook Road
    Raleigh, NC 27610

Please note that the email you send to us may not be secure, and as a result, your personal information in the form may be exposed during transmission or while it resides in your email account or on your computer. For that reason, you may prefer to mail or fax your request form to us

Obtaining a Copy of Your Medical Record or Bills

You have the right to request to see and receive a copy of your PHI contained in clinical, billing and other records used to make decisions about you. We may charge you the following fees when you request your records for your own personal use:

  • $6.50 flat fee for “Patient Directive Requests” + fees as applicable.

You can receive your records in any of the following ways, and you just need to let us know your preference by checking the applicable box in the request form:

  • Mail
    Your medical records will be processed by Ciox Health within 3-5 business days of receipt of your completed authorization form. The invoice for payment will be received along with your medical records. Payment is expected upon receipt.
  • Pickup
    You can pick up your records upon notification that they are ready at:
    Health Information Management
    500 Eastowne Drive, Chapel Hill, NC 27514
  • Secure E-Mail
    We will send an email to the address you provided on the authorization form. The email will contain a secure link to download or print your medical records within 1-3 business days. You will be invoiced upon receipt from Ciox Copy Service (formerly Healthport).
    Note: No postage fees will apply.
  • Fax
    We will fax your key medical record information to another health care provider upon your request. Typically, your request will be processed within 3-5 business days of receipt of your completed request form. We will let you know in writing if there is a delay.

Restricting the Use and Disclosure of Your Medical Records

You may request that we restrict the use and disclosure of PHI about you, but we are not required to agree to your requested restrictions except in limited circumstances further described in the UNCHCS Notice of Privacy Practices.

Requesting an Alternative Means of Communication

You may request how and where we contact you about PHI. We will accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment will be handled and your specification of an alternative address or other method of contact.

Requesting an Amendment to Your Medical Record

You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you. We will evaluate and determine whether it is proper to comply with your request, and we will notify you in writing of whether we complied with your request. Typically, your request will be processed within 60 days of receipt of your completed request form. We will let you know in writing if there is a delay.

Requesting an Accounting of Disclosures of Your Medical Record

You have the right to receive a written list of certain disclosures we have made of PHI about you. If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee. Typically, your request will be processed within 60 days of receipt of your completed request form. We will let you know in writing if there is a delay.

Notice of Privacy Practices

You can find detailed information about your privacy rights as our patient, and how to exercise them, in the UNCHCS Notice of Privacy Practices

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