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Health Information Management

Contact Information

PUSH - Room 140
601 Stadium Mall Drive
West Lafayette, IN 47907
Fax: 765-496-1907

Release of Records Phone: 765-494-1838

Immunization Information Phone: 765-494-1837

Health Information Management (HIM) at PUSH is responsible for a variety of functions that include:

  • Release of Information
  • Amendment to Patient Records

Release of Information

Medical records are kept for 7 years, and may be retrieved through the HIM department. To obtain medical records, a valid authorization must be completed and signed by the patient if over 18, or parent/guardian if under 18. HIM will process the request and provide records to the authorized party within 30 days.

Current students wishing to allow others access to their medical records may submit a completed authorization form, or locate an electronic form on the homepage of the patient portal. Patient who do not have access to the Patient Portal may obtain their records by completing the authorization form or they may contact HIM at 765-494-1838 to obtain an electronic authorization form.

Sample Authorization Form

Paper Authorization

Amendment to the Patient Record

If you believe that there is a mistake in your health information or that a piece of important information is missing, you have the right to request that we amend the existing information. You must provide the request and your reason for the request in writing to the HIPAA liaison at the location listed at the top of this notice. We may deny your request in writing if the health information is: 1) correct and complete; 2) not created by us; 3) not allowed to be disclosed, or 4) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you do not file a statement of disagreement, you have the right to ask that your request and our denial be attached to all future disclosures of your health information. If we approve your request, we will make the change to your health information, tell you that we have done it, and share the updated record with those that have previously received this information.

Amendment Request Form