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Medical Release Forms

Looking to obtain a copy of your medical records?

Paper Copy of Medical Records:

Please complete the following steps to obtain a paper copy of your medical records:

  1. Print and complete the Medical Records Release Form.
  2. Complete, sign and date the form. In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver’s license, military I.D. or state I.D.).
  3. Mail, fax or personally deliver your paperwork to the facility where you were treated.

Mail

Nashville Health Information Management Service Center – Release of Information
552 Metroplex Dr
Nashville, TN 37211

Phone: (615) 695-8700
Fax: (877) 865-9738


For further information or assistance call (866) 270-2311.


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Medical Records Release

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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 (877) 865-9738 indicating the patient's name, date of birth and date of visit in the facility. For assistance call (866) 270-2311.


Insurance, Attorney, Disability and Third Party Requests

Requests should be sent from your insurance company, attorney, or Disability Determination Service and mailed to the address below. We cannot accept faxes and email requests.

Mail request to:

Nashville Health Information Management Service Center – Release of Information
552 Metroplex Dr
Nashville, TN 37211

Phone: (866) 270-2311