Medical Records & Forms

Records & Forms

Do You Need Your Medical or Immunization Records? 

If you are a current student, faculty or staff, follow these directions to obtain a copy of your medical records:

  1. Go to the Patient Web Portal.
  2. Log in with your UARK credentials.
  3. Select the "Medical Records" tab on the left side navigation.
  4. Then select the appropriate tab at the top of the page that you would like to view/print your medical record for (i.e. Visits, Problems, Allergies/Meds, Radiology, Labs, Procedures).
  5. The "Referrals" tab will hold medical refferals.
  6. The "Immunizations" tab houses all your immunization records for vaccinations received at our facility and any you submitted to us. 
  7. If you cannot locate what you are looking for, follow the procedure below.

Personal medical information and records are confidential, so a signed authorization form is required to receive a copy of your medical records. 

If you no longer have access to your web portal, follow these directions to obtain a copy of your medical records:

  1. Complete the Release of Medical Records Form (form can also be picked up at the health center). Note: All fields need must be filled in. Be sure to sign and date the bottom of the form.

  1. Email a completed authorization form and a copy of photo ID to: Buena Burks, Health Information Management Specialist.

Please allow up to 7-10 business days for processing.

Medical Records Charges: $10.00 (processing fee) plus $0.50 per page for first 25 pages ($0.25/page after). No charge for physicians/medical institutions.

Other Charges:

  • Verification of psychiatric disability: $50.00

  • Radiology images: $5.00

The health center can accept payment by Apple Pay, Google Pay, VISA, MasterCard, American Express, Discover, or Razorbuck$. Charges can also be applied to your student UAConnect account.

Questions? If you have any questions or would like to follow up on the status of your record request, please contact the Health Information Management Specialist, Buena Burks, or call 479-575-4477.

Medical Records Fax: 866-409-1980


Absence Explanation

Authorization for Treatment of Minor

Immunization Compliance

Physician Request for Lab Orders

Pat Walker Health Center Charges Policy

CAPS Release of Information Authorization

Patient Rights & Responsibilities (Medical)

Release of Medical Records (only use this form if you can't request it via your Patient Web Portal)

Class Excuse Policy

The Pat Walker Health Center does not provide class excuses.

Because of federal health care privacy regulations, we cannot release protected health information (including dates and times services performed). 

If an illness prevents a student from attending classes for an extended period of time, the Dean of Students will be notified with the student’s permission.

Students and faculty may find it useful to use the Absence from Class Form as a means to have appropriate communication about class absences.