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UNIVERSITY of ARKANSAS PAT WALKER HEALTH CENTER |
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Medical Clinic |
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Medical Records Request Medical Record Services maintains all records of patients seen in the Primary Medical and Women's Clinics at the Pat Walker Health Center. With proper authorization, the patient may obtain a copy of his/her medical and/or immunization records for a nominal fee. Request for information are completed upon receipt of an authorization within 7 - 10 working days. Because your medical information is confidential and requires high levels of security, an authorization form with your signature on it must be completed prior to processing. There may be charges associated with your request and payment must be made prior to your records release. Our cashier is located on the 1st floor of the Pat Walker Health Center. We accept cash, check, VISA, MasterCard, Discover, and RAZORBucks Cards. Please make checks payable to University of Arkansas. See below for charges that may apply. Directions for Completing an Authorization Form 1. Download the authorization form (642 kb) and print it on any printer. The authorization form is an interactive pdf file and requires Adobe Acrobat Reader software to read. (Free Adobe Acrobat Reader software is available.) If you encounter problems, please call 479-575-4078 2. Complete authorization form in its entirety. Be sure to sign and date the bottom of the form. If you have any questions on how to complete the authorization form please contact us at 479-575-4078 If any portion of the form is incomplete, it will be returned to the requester and cause a delay in processing 3. Mail authorization form to : Pat Walker Health Center Medical Records Services/HIM 525 N. Garland Ave. Fayetteville, AR 72701 or fax to 479-575-8793 Charges for Medical Records Services:
If you have any questions or concerns please contact Medical Record Services at 479-575-4078 or fax at 479-575-8793
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