Health Information Management

The Student Health Services recognizes the right to privacy of each individual to whom health care is provided. Health Information Management (HIM) and Referral staff are responsible for preserving the privacy and confidentiality of patient information in all its stages of development and use. Medical information will not be released to parents, friends, faculty and administration, and future employers without an Authorization for Release of Medical Information signed by the patient. However, records may be shared in the event of a medical emergency (e.g. patient is incapacitated), if subpoenaed or required by law.

Except in life threatening emergencies, or unless required by federal, state, or local law(s), your medical information will not be released without your permission. On occasion, Campus Health receives telephone calls from parents about your medical care. If you are over 18 years of age or older, the health care providers are unable to release any medical information to your parents without your explicit verbal or written permission. We do not allow for students to sign a “blanket” authorization form. What you might want to release to a third party now, you might not want to release at a later date. You will need to sign a release form each time you want new information released from your records.

Our staff will assist patients by processing requests to release or obtain health information and by managing patient referrals (sending a patient for medical tests or to a specialist outside of the SHS). Our staff will coordinate the process by ensuring a signed records release authorization is on file, finding a doctor that participates with your insurance, scheduling an initial appointment and sending medical information pertaining to your referral, if applicable.

All persons presenting for medical care for the first time will be asked to indicate their consent for treatment and acknowledge receipt of the Notice of Privacy Practices. The Notice of Privacy Practices is available on our website and at the SHC Front Desk.

record requests

1. Patients must complete and sign an Authorization For Disclosure of Protected Health Information Release form.

2. Send along with a copy of your photo ID.The form must be signed and dated. Requests without signatures or photo ID will be returned.

3. Once the form is completely filled out/signed: Mail, fax or hand delivered the form to the Health Information Management and Referrals Department.

4. Be advised, there is a charge for medical record / x-ray cd copies. Please call 336-334-5340 (option #2) for pricing.

5. There is no fee for immunization / vaccinations copies.

6. Please note we cannot accept the form via email.

7. We will send the requested information as requested. If picking up records, please go to the Front Desk at Anna Gove Health Services 107 Gray Drive.

Requests may take up to 3 to 4 business days to be processed. Information pertaining to alcohol or other drug dependencies and HIV test results require a release specific to that information. All releases must be signed by the patient.

We accept medical information from off-campus by mail, fax or it can be hand delivered. 

NOTE: All outside medical records sent to the SHS will not be reviewed until the patient has been seen by a SHS provider.



  • Log on the SHC Patient Health Portal
  • Select the Immunizations tab
  • Select the green print button on the immunization page is displayed.
  • No Authorization for Release of Medical Information needed!
  • Retain copies of your immunization records for future use.

Power of Attorney (POA). This person can make financial and legal decisions on behalf of his or her student. However, this does not allow the Student Health Center to release medical bills and patient records due to the nature of the protected health information.

To make medical decisions on behalf of his or her student, the individual would need a Medical or Health Care POA. This person is then able to make medical decisions for his or her student in the event that the student is unable to do so. For example, the student is in an accident and cannot make decisions about treatment.

If a student has legally designated an individual POA or Medical POA, this document should be kept with the designated POA and with the student. The Student Health Center can scan a Medical POA into a student’s electronic health record for reference. If the student is being seen at a local hospital or different health care facility, this information would need to be provided directly to that facility by the student or designated POA. Consult an attorney to discuss your needs and state requirements.

Student Health adheres to both state and federal laws that protect the confidentiality of your health records. Federal law only allows the Student Health Services to release your protected health information (PHI) to anyone (including parents and faculty) with your expressed written permission, except under certain very rare circumstances.

The Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA) govern the release of students’ medical records.The Student Health Center only releases a student’s medical records to parents or guardians in two cases:

  • If the student is under the age of eighteen.
  • If the student gives written consent for release.

The Health Insurance Portability and Accountability Act (HIPAA) also governs the release of non-student health records. The Student Health Center will release protected health information (PHI) to designees upon receipt of written authorization.

medical release form


Phone 336.334.5340 (Option #2)

Fax 336.334.5343

Location: 1st Floor Anna M. Gove Student Health Services

Mailing Address:
UNC Greensboro, Student Health Services
Attn: Health Information Management
107 Gray Drive, Greensboro, NC 27412-0511

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