In compliance with HIPAA regulations, Atlanta Colon and Rectal Surgery, PA requires a “Release of Medical Record Information,” a “Request to Copy and Inspect Records” and “Request for Correction/Amendment of Protected Helath Information” in order to release or amend a patient’s medical record.

Medical records are processed through each physician’s nurse. Administrative fees may be associated with some types of requests.

Typically, there are four types of requests:

Medical Records for Self

Step One: Print and completely fill out the “Request to Copy and Inspect Records” form.

Step Two: Fax or Mail the request to the appropriate Atlanta Colon and Rectal Surgery location.

Step Three: Allow 2-3 business days for your request to be processed.

Third Party Requests (Health/Life Insurance Co, Disability Insurance, Employer, etc)

Step One: Print and completely fill out the “Release of Medical Record Information” form.

Step Two: Fax or Mail the request to the appropriate Atlanta Colon and Rectal Surgery location.

Step Three: Allow 2-3 business days for your request to be processed.

Medical Record Requests for Doctor and/or Facility for Treatment Purposes

Step One: No forms are necessary. You may call and/or fax this request. Provide the doctor’s name, phone number, fax number, and/ or mailing address to the appropriate physician’s office.

Step Two: Allow 2-3 business days for your request to be processed. If the request is urgent, please have your doctor’s office call the appropriate Atlanta Colon and Rectal Surgery location.

Medical Record Amendment Requests

Please complete the first page of the Request for Correction/Amendment of Protected Helath Information form. Mail the form to the appropriate physician’s office.