Request Records

An authorization form is required when you are requesting copies of medical records or asking that we disclose your health information to 3rd parties. If you need your record copies to be sent to another health care provider for treatment purposes, please print this form and follow the instructions listed on the form.

We cannot fulfill medical records requests via email or an online form. In some cases, a fee will be charged for medical record copies. If you have questions about instructions, turnaround time or fees, please call (205) 510-5000.

Request Records Form

Monitor with a heart drawn on it.

 

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