Mission Health Hospitals Medical Records

Patient Requests

Please complete the following steps:

1. Download, print and complete the authorization form. The authorization form must be signed and dated.
   1. Authorization for Release of Medical Information
   2. Authorization for Release of Medical Information – Spanish
2. In order to verify your identification and validate your authorization, we require a legible copy of a valid photo I.D. (e.g., driver’s license, military I.D. or state I.D.).
3. You may send your request in the following ways:
   Fax: 844-481-0298
   Email Requests
   Mail:
   PO Box 290789
   Nashville, TN 37229-0789
4. To obtain Radiology Images, please contact the Radiology Department directly at (828) 213-0814
5. To obtain a certified copy of your Birth Certificate please contact your state or local Vital Statistics Office.

• Records delivered by mail will be shipped within 5-7 Business days after processing.
• Records delivered by email will be received within 1-2 Business days after processing.

For questions regarding medical records, or to obtain the status of your request call us at (844) 481-0278.

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 678-325-0357 indicating the patient's name, date of birth, date of visit and the name of the facility where you were treated. Please indicate "STAT" for all urgent requests. For assistance, call 877-302-7338.

Non-patient Requests (Insurance, Attorney, Disability and Third Party Requests)

Requests should be sent from your insurance company, attorney, or Disability Determination Service and be mailed to the address below. For assistance, call 877-302-7338.

Mail request to:
PO Box 291569
Nashville, TN 37229-1569