Request Medical Records

Patients can complete:

• Patient Right to Access: Request for Medical Records form - English
• Patient Right to Access: Request for Medical Records form - Spanish

Memorial Hermann will respond to your request within 15 days of receipt. A cost-based fee, including only the cost of labor for the production of the information requested and supplies for creating the information, along with possible postage, may be assessed.

Many affiliated physicians at Memorial Hermann have access to your health information through the electronic medical record. Simply ask your health care provider to review your medical records and imaging studies online.

For physicians or health care facilities not affiliated with Memorial Hermann, you can request that we transfer your medical records by completing the form below.

• Patient Request to Have Medical Records Transferred to Another Health Care Provider - English
• Patient Request to Have Medical Records Transferred to Another Health Care Provider - Spanish

In addition, your physician can also ask that your health information be sent to their office by requesting your medical records on his/her office letterhead and faxing back to the Release of Information Department.

You can call (713) 778-2545. Or request your imaging records here.

To obtain a copy of your itemized billing statement, please call (713) 338-5502.

A patient has the right to request an amendment to information contained within his/her medical record. Complete the form: Request to Amendment of Protected Health Information.

You have the right to receive an accounting of disclosures of protected health information made by Memorial Hermann in the six years prior to the date on which the accounting is requested. Complete the form: Request for Accounting of Disclosures.

When requesting medical records acting as the medical power of attorney, we will ask that you supply a copy of the medical power of attorney as well as the physician statement citing that the patient is unable to make medical decisions.

You may complete one of our authorization forms listed below, and give this form to the third party requestor to mail to Memorial Hermann with a cover letter.

• Authorization to Release Patient Information Form - English
• Authorization to Release Patient Information Form - Spanish
• Authorization to Release PHI Concerning Patient in Alcohol-Drug Abuse or Mental Health Treatment Program

Yes, you can access your medical record by logging into the My Memorial Hermann™ patient portal.

If you were an Everyday Well user, you will be able to access legacy Everyday Well medical information from May 2021 to 2024 through your MyChart account in My Memorial Hermann™. Everyday Well users seeking assistance requesting medical records created prior to May 2021 may call (713) 222-CARE (2273). If you are a patient of a Memorial Hermann independent affiliated physician, please contact your provider for instruction on accessing medical information prior to May 2024.