As a patient of UMSL Eye Care, you have a right to your medical record. Please complete the Medical Record Release Form, sign it with an original signature, and submit by fax or US mail to Cassidy Cooley, Compliance Specialist, at:

UMSL Eye Care
ATTN: Medical Records
1 University Boulevard
St. Louis, MO 63121
Fax: (314) 516-6405

Be sure that your form includes the correct contact information for the party you wish to have your records released to.

Please note that medical records requests can take up to 30 days to fulfill; requests related to special reports (i.e., The Pupil Project) are subject to the completion and evaluation of recommended testing, and may take 12 weeks to fulfill. Records can be sent to whomever you designate, via fax, US Mail, or via UM Secure Transmit. Details regarding costs of records duplication and Secure Transmit are specified on the release form. There is no charge for records released to another healthcare provider, and there is no charge for a copy of the most recent patient exam. Other charges are based on the Missouri State Recommendations for Records Duplication. For questions, please contact the Compliance Specialist at (314) 516-6064.

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