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Patient Requests

To request a copy of your medical records, follow the steps listed below:

  1. Download, print and complete the access request. The request form must be signed and dated.
  2. In order to verify your identification and validate your authorization, we require a legible copy of a valid photo I.D. (e.g., driver’s license, military I.D. or state I.D.).
  3. You may send your request in the following ways:
  • Records delivered by mail will be shipped within 5-7 Business days after processing.
  • Records delivered by email will be received within 1-2 Business days after processing

For questions regarding medical records, or to obtain the status of your request call us at (470) 903-2494

Urgent Requests, Records for your Physician

For immediate continuity of care, your healthcare provider can request records.

The physician office must fax a written request on their letterhead to (478) 275-6828 indicating the patient’s name, date of birth, date of visit and the name of the facility where you were treated. Please indicate “STAT” for all urgent requests. For assistance, call (470) 903-2494.

Non-patient Requests (Insurance, Attorney, Disability and Third Party Requests)

Requests should be sent from your insurance company, attorney, or Disability Determination Service and be mailed to the address below. For assistance, call (470) 903-2494

Mail request to:

2121a Bellevue Rd
Dublin, Ga 31021