Medical Records & Authorizations

Follow the procedure outlined on this page to securely request your personal medical records

Where to start: Complete an authorization form

Tri Rivers patients can request their medical records by printing and filling out an Authorization for Release of Protected Health Information form. The form, completed in its entirety, is needed to authorize the release of health records, even for personal use. HIPAA guidelines state that authorization forms cannot be altered after they are signed and submitted to Tri Rivers.

Processing of medical records and related fees

Tri Rivers uses the independent company, CIOX Health, to process medical records requests for all entities (for example, a disability or auto insurance carrier) other than another healthcare provider. Please call CIOX Health directly at 1-866-425-0174 to check the status of your records release. Related to Tri Rivers’ processing fees, please note the following:

  • Tri Rivers and CIOX Health observe the state-regulated fee schedule to copy and release medical records.
  • Tri Rivers charges a $15 fee for completion of most forms, including — but not limited to — disability, Aflac and Family and Medical Leave Act (FMLA).
  • All applicable fees are payable upon request for medical records or form completion.
  • Due to the large number of requests, forms are completed 10 to 14 business days after submission. 

Submitting your completed authorization form

Completed authorization forms can be hand-delivered to any of our six main physician office locations or can be sent to either the fax number or mailing address below:

Fax:      412-630-8019
            Attn: Forms & Medical Records Department

Mail:    Tri Rivers Musculoskeletal Centers
           Attn: Forms & Medical Records Department
           7500 Brooktree Road, Suite 302
           Wexford, PA 15090
           (Please do not hand-deliver to this location.)

If you have any specific questions, please direct them to the appropriate department:

Disability Forms or FMLA Paperwork at 412-367-5814, ext. 166
Patient Medical Records Request at 412-367-3851
Workers’ Compensation at 412-367-3841