How do I receive a copy of a medical record?

Medical Reports are confidential documents protected by the Health Insurance Portability and Accountability Act(HIPAA).
To request a medical report you must complete a Medical Consent Form for Disclosure of Medical Information (see link at bottom of page). This form must be notarized. NO EXCEPTIONS! Do not sign it until in the presence of a notary. There is a notary in the office where the report must be taken (Station 1 at 2939 Altruria Rd., on the corner of Altruria Rd. and Stage Road). You must show proof of ID.
If the patient is a minor, you must show the birth certificate of the patient. If the patient is not a minor and deceased, a power of attorney document, marriage license or death certificate must be provided. Request have been rejected due to patient was alive and in the hospital, unable to come to the office and spouses requesting the record.
We are very strict on these rules to protect patient identity and medical information.
There is no fee for the first 5 pages and $0.25 for each additional page.
These can normally be processed immediately.

Medical Consent Form

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1. Why does the ambulance crew ask for my insurance information?
2. How do I receive a copy of a medical record?
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