Medical Records Request
Urologic Specialists of Northwest Indiana has partnered with Sharecare to fulfill your requests for records.
For Patients & Legal Guardians
Urologic Specialists of Northwest Indiana is committed to protecting your medical information.
For information about your rights and the obligations you have regarding the use and disclosure
of your medical information, please see our Notice of Privacy Practices.
View Notice of Privacy Practices →
If you are our patient and would like to request your medical records, please click on the link
below to complete your request. You will be required to provide a valid email address and a
government-issued ID.
Only the patient, parent/legal guardian, or the patient’s legal health care representative can
sign the form to release medical records. If you are requesting records on behalf of the patient
or as the patient’s representative, please provide a copy of an
Advance Directive, Durable Power of Attorney for Healthcare, or
Conservatorship.
For Third-Party Requesters
If you are an attorney, insurance company, or any other entity requesting records from our facility, please click on the link below to upload your request along with the patient’s authorization.
Your records will be ready in 3-5 business days from the receipt of your electronic request.
You may call: 858-244-1811
Or contact support for live chat: Start Live Chat
