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Medical Records Request

For patients of UT Health North Campus Tyler (formerly UT Health Northeast)

To request a copy of your medical records, please fill out the form below. You may mail or fax it to:

Release of Information

11937 US Hwy 271

Tyler, TX 75708

Phone: 903-877-7985

Fax: 903-877-5123

Medical Records Request Form (English)

Medical Records Request Form (Spanish)


For patients of all other UT Health East Texas hospitals

To request a copy of your medical records, please fill out the form below. You may email it to uthealthrequests@mrocorp.com or fax it to 903-535-6178.

Medical Records Request Form