This Release of Information is intended for current patients of the Health Center at Auraria. This form is to be used to request medical records be sent directly to another facility for continuation of care, for students requesting immunization records be sent to an employer/school, or for patients requesting a personal copy of their medical records. If you are a new patient and would like records sent to us from your current provider, please request records by contacting your current provider and asking for records to be sent directly to the Health Center at Auraria.

The HIPAA regulations have additional guidelines for the release of Mental Health records. If you are requesting Psychiatry/Psychological records to be released, please stop into the Health Center at Auraria to complete the Authorization to Release Protected Health Information.