Medical Records Request
For the convenience of patients, Urology Austin has partnered with the Healthmark Group in providing a secure, on-line method to request medical records. On-line requests are also accessible to third party vendors acting on behalf of patients.
Read through the following steps in order submit your medical record request:
- Click this link to be directed to Healthmark’s secure site. New users will need to create an account.
- Once on Healthmark’s site, choose “Requestors”.
- Log into the MedRelease tool found on the Healthmark site. New users will need to create an account.
- After logging into MedRelease, choose “Submit Request” (found on the left-hand side of the page) to fill out a HIPAA-Compliant Medical Records Release Authorization form.
- Once this on-line form has been completed, choose “Authorize Release” located at the bottom of the page.
After authorizing the release of records, your request will be processed by the Healthmark Group. Once complete, you will be notified by email, or through standard mail, on how to retrieve your records. Patients who supply an email address will receive their notifications faster than by standard mail.
Medical records status or help with requesting medical records
Patients who have questions about completing the medical records request, or who would like to check the status of their request can contact the Healthmark Group at:
By Phone at 800-659-4035
By Email at email@example.com
Medical Records Request
New Patient Forms
Please click here New Patient Forms Bundle to print all 8 forms at one time.
To print individual forms please click the desired form below.
- Patient Registration Form
- Medical History Form
- Patient Portal Consent
- Financial Policy Notice
- Consent to Release Protected Health Info & Assignment of Benefit
- UA Notice of Privacy Practices
- No Show Acknowledgement Form
- Patient Email Consent
Haga clic aquí Paquete de nuevos paquetes de pacientes para imprimir los 5 formularios al mismo tiempo.
- Informacion del Paciente
- Consentimiento Para Divulgar Información Medica Privada y Asignación De Beneficios
- Historial Medica
- Poliza Financiera
- Portal del Paciente
- Póliza de No Presentarse y Cancelación de Ultimo Aviso
- Política De Consentimiento De Correo Electrónico Del Paciente
Educational Resources for Patients
- Prostate Biopsy Booklet
- Pelvic Organ Prolapse
- Men’s HRT Booklet
- Low T Booklet
- InterStim Booklet
- Incontinence Package
- I C Booklet
- Women HRT Booklet
- Vasectomy Spanish Booklet
- Vasectomy Post OP Booklet
- Vasectomy Packet
- Vasectomia Post Op 1 Spanish Booklet
- Urodynamics Male Booklet
- Urodynamics Female Booklet
- Urinary Tract Infection Booklet