Request Medical Records
Walk-in hours
Monday – Friday 7:00 a.m. – 4:30 p.m.
Holiday hours may vary
Telephone hours: 706.282.4283
Monday – Friday 7:00 a.m. – 4:30 p.m.
How To Request Copies of Medical Records
An “Authorization To Disclose Medical Information” must be completed in order to process a request for copies of medical records.
Please print and complete the form below:
Authorization To Disclose Medical Information
In Person
You may pick up a copy of your medical records in person. An “Authorization To Disclose Medical Information” form must be completed in order to process a request for copies of medical records. There is no charge for records requested for continuation of care.
Physical Address / Mailing Address:
Stephens County Hospital
ATTN: Medical Records
163 Hospital Drive
Toccoa, GA 30577
The most convenient entrance to access the Medical Records department will be through the rear of the hospital – the Dome Entrance. Enter through the doors to the left in the Dome (New Impressions entrance). Continue through the New Impressions – Maternal Services lobby, there will be an elevator located to your left. Take the elevator to the 2nd floor, it will open into the lobby of the Medical Records department. There will be a phone located on the wall. This phone will access Medical Records personnel who can assist you with your request.
By Mail or Fax
When requesting a copy of your medical records by mail, an “Authorization To Disclose Medical Information” form will be mailed to you. You must complete the form and mail it back to the Medical Records department before your request can be processed. Your medical records will then be mailed to you. There is no charge for records requested for continuation of care.
When requesting a copy of your medical records by fax, an “Authorization To Disclose Medical Information” form must be completed and returned before your request can be processed.
Fax: 706.886.8045
Please Note;
- We will be unable to process incomplete forms.
- Please include your telephone number in the event that we have any questions regarding your request.
Information Regarding Medical Records Request
Children’s Records: Before your child’s medical records can be released, the parent/legal guardian must complete an “Authorization To Disclose Medical Information” form. If the child is over the age of 18, he/she must be the one to request the information. There is no charge for records requested for continuation of care.
Power Of Attorney Request: All Power Of Attorney request for release of medical records can only be processed for an individual with a Power Of Attorney designated for health care - Power Of Attorney For Health Care.
Attorney Request: All records requested by an Attorney’s office will be subject to processing/certification fees. Please note that records not certified will not be admissible in court.
Disability Request: All records requested for Disability cases will be subject to a processing fee.
Medical Records Fees: Please see the fee schedule for the most current fee requirements.