All patient information and medical records are maintained by CHI St. Alexius Health. For assistance with medical records please see the staff at the clinic or call CHI St. Alexius Health medical records department at 701.530.6628. You may also send your request via e-mail to firstname.lastname@example.org.
In order to maintain the privacy and confidentiality of student medical information, the University of Mary Student Health Clinic Student strictly abides by the provision of the Health Insurance Portability and Accountability Act of 1996 ( HIPAA). The clinic does not release student information without a release signed by the student on file. It is important for students to understand that the release of information required by HIPAA is different from the release of information required by the Family Educational Records and Privacy Act (FERPA). FERPA has to do with most of the student’s other records at the university.
Release of Information Forms
The form required to authorize the University of Mary Student Health Clinic to release information to parents or other family members as well as to other medical providers is available at the following link ( please allow seven to 10 business days for this release to be processed).
Release of Information form: This form is necessary to release information to another medical facility, family, or the patient. There may be a fee involved. Please allow at least three to seven business days for processing this request. Click here to download the form.
Students may request their immunization records by contacting the Student Health Clinic at (701) 355-3770. Due to confidentiality requirements, immunization records can only be released to the students themselves.
The following information will be needed to process an immunization records request:
- Your full name
- Your date of birth
- Last date you attended the University of Mary
- Your complete mailing address and fax number to which you wish your records sent
Students should keep a copy of their Immunization Record for a personal file and photocopy as needed. Students will need to provide documentation of immunization status throughout their lifetime.
For records from Student Health Clinic services received prior to January 8, 2018 please call Mid Dakota Clinic at 701.530.8061 or 800.472.2113 ext. 6081.