Release of Medical & Counseling Records
for UNM Student Health & Counseling

A written authorization from the patient is required in order for UNM Student Health & Counseling (SHAC) to release medical information or copies of a patient's chart. The following SHAC Release of Information form can be mailed or faxed to Student Health and Counseling:

UNM SHAC Release of Information Form (.pdf)

** PLEASE NOTE: Click here for information about release of health information for UNM Health Sciences Center / UNM Hospitals.) **

A patient may also send a letter to UNM SHAC with his/her full name, address, social security number, date of birth, phone number, signature, and the specific information requested. There may be a fee for the information released.

If mental health information is requested, additional information may be required. The information will be mailed to the address on the release form or letter of the request. Requests should be mailed or faxed to:

Medical Records Department
UNM Student Health & Counseling (SHAC)
MSC06 3870
1 University of New Mexico
Albuquerque NM 87131-0001

FAX: (505) 277-2020

For more information, call UNM SHAC at (505) 277-3136.


Release of Medical & Counseling Records
for UNM Health Sciences Center

UNM Health Sciences Center - Release of Information Form (.pdf)

UNM HSC Phone: (505) 272-2141
UNM HSC Fax: (505) 272-0468


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