Medical Records/Release of Information

Release of Information form for University of Iowa Health Care Medical Center Downtown (Formerly known as Mercy Iowa City Hospital & Clinics)
If you need to request records from the University of Iowa Hospitals & Clinics, please use this link to navigate to their Medical Records Request webpage: https://uihc.org/medical-records-request or call 319-356-1719
Please have your provider's office contact us or fax over a coversheet requesting the medical records.
All other requests for copies of medical records must be received in writing.
Print a copy of the form.
If the patient is a minor (less than 14 years of age), a parent or legal guardian must sign the authorization.

This form must be completed, signed and dated, then mailed, emailed or faxed to Health Information Management at:

Release of Information Coordinator
500 E. Market St
Iowa City, IA 52245
Phone: 319-339-3609
Fax: 319-339-3785
Clinic email address: mercyservices@scanstat.com
Hospital email address: mercyic@scanstat.com