Medical Records and Forms
Medical Records
Our medical records request process ensures your medical records are safely and confidentially maintained, while providing you ready access when you need them. Keep reading to learn more and download forms.
You can access portions of your electronic medical record online with MyAtriumHealth. That includes things like your medical history, test results and immunization records.
How to Request Your Medical Records
Submit your records request electronically via your MyAtriumHealth portal.
- Log in to your MyAtriumHealth account.
- From the main page click on Menu in the top left corner. Under the "Communication" section, select "Request Medical Records"
- Fill out the questionnaire entirely and click continue. Review your form and click Submit.
To request a copy of your medical records/imaging for yourself or to send to your healthcare provider, complete a Patient Request for Access Form
To request a copy of your medical records/imaging to be sent to an insurance company, attorney, school or other organization, complete an Authorization for Release of Health Information form.
Submit your completed forms via one of the options below:
MailAtrium Health Navicent
Corporate Health Information Management Release of Information
777 Hemlock St. MSC#148
Macon, GA 31201
Fax
478-633-7818
Email a PDF or image of your completed form to MedicalRecordsROIMacon@Atriumhealth.org. Prior to sending your authorization by email, review our Guidelines for Electronic Communications. Please call us at 478-633-1067 if you have questions or would like a blank form mailed to you.
Billing Records
To request your billing records, please contact the business office at 704-512-7171.
Pathology Slides
To request pathology slides, please contact the Pathology Department at 478-633-1329.
Radiology Images or Imaging Films
To request your radiology images, please contact the Radiology Department 478-633-1235.
Birth or Death Certificates
Birth and death certificates are legal documents managed by the state. Please contact your local agency below:
Georgia Department of Public Health - Vital Records
Immunization Records
If you need additional information regarding your immunization records, please contact your state's immunization office.
Requesting a Correction or Addition (Amendment) to Your Medical Records
Submit your amendment request via your MyAtriumHealth portal.
- Log in to your MyAtriumHealth account.
- From the main page, click on Menu in the top left corner. Under the "Communication" section, select "Request Health Information Change"
- Fill out the questionnaire form entirely and click continue. Review your form and click submit.
Complete, date and sign the Health Information Amendment Form
Submit your completed forms via one of the options below:
Atrium Health
Corporate Health Information Management Release of Information
PO Box 32861
Charlotte, NC 28232
Fax
704-446-6037
Email a PDF or image of your completed form to MedicalRecordsROI@atriumhealth.org.
Prior to sending your authorization by email, review our Guidelines for Electronic Communications.
Please call us at 704-667-9500 or toll-free at 844-383-2109 if you have questions or would like a blank form mailed to you.
Need Assistance?
Customers needing assistance may call our service center at 478-633-1067 to speak to a live representative.
Frequently Asked Questions
Review outlined instructions above in the “How to Request Medical Records” section.
Minors (patients under 18 of age): The parent or legal representative must complete, sign and date the Patient Request for Access Form or submit a medical records request via the minor's MyAtrium Health account, unless the minor is emancipated. A legal guardian may be asked to provide proof of guardianship.
Note: If minor consented for their outpatient treatment for pregnancy, sexually transmitted disease or behavioral/mental health without parental consent, the minor may sign the Patient Request for Access Form. When the patient is a minor being treated for substance use, the minor and the parent both may be asked to sign the Patient Request for Access Form, regardless who consented for treatment.
Patients 18 and older: Under most circumstances, patients over 18 must sign or request records themselves. If the patient has a legal guardian or representative, the legal guardian must provide proof of authority in order to complete the Patient Request for Access Form/ Authorization to Release Information Form or submit a request via the patient's MyAtrium Health portal on behalf of the patient.
Deceased patients: To obtain a copy of a deceased patient's record, you must complete, date and sign a Patient Request for Access Form and provide proof of authority and identity, such as:
- Executor of Estate or Court Order Administrator
- If there is no Executor of Estate or Court Order Administrator, a notarized Affidavit of Next of Kin form must be completed. Affidavit-Next of Kin of Decedent
- A death certificate may be requested. Additional proof of authority may be requested, as appropriate.
No. Our medical records request process ensures your medical records are safely and confidentially maintained, while providing you ready access when you need them.
All Medical Records Forms
- Authorization for Release of Health Information: English | en Español
- Instructions for Completing the Authorization for Release of Health Information: English | en Español
- Patient Request for Access: English | en Español
- Instructions for Completing the Patient Request for Access: English | en Español
- Authorization for Release of Psychotherapy Notes: English | en Español
- Medical Records Privacy Rights: English
- Health Information Amendment: English | en Español
- Patient Request for Protected Health Information Release Restriction: English | en Español
- Request for an Accounting of Disclosure of Health Information: English | en Español
- Revocation of Authorization for Release of Health Information: English | en Español
At Atrium Health, we want to help patients understand their privacy rights. We also want patients to understand how to exercise these rights and what to expect from Atrium Health. Learn more about your Medical Records Privacy Rights.
How Third Parties Can Request Medical Records
Individual Patient Requests
Anyone needing medical records for one patient should submit requests and any required authorization using one of the delivery methods listed above.
Multi-patient Requests
Health plan administrators, health care providers or HIPAA business associates needing electronic data for multiple patients (including Healthcare Effectiveness Data and Information Set [HEDIS], risk, audits or studies) should submit requests to medicalrecordsroi@advocatehealth.org (NC/GA).