Medical Forms

If you are currently or have previously been a patient at any PPWP health center and would like a copy of your records for yourself or your current health care provider, you can download records request forms here:

Release of Records to Self (.docx) (.pdf)
Release of Records to a Third Party (.docx) (.pdf)

Current patients of PPWP can also access their records through the Patient Portal website, or by filling out this Google form.

For assistance in obtaining any information you are having difficulty locating, call 412-434-8971, or send us a patient portal message.

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Or call 1-800-230-7526

Medical Forms

Planned Parenthood of Western Pennsylvania

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