If you wish to obtain medical records for your personal use, we will assist you in this process. We reserve the right to charge for printed copies or to cover the cost of staffing and equipment.
Authorization to obtain Protected Health Information
All requests for medical records must be fully completed and dated to be processed. Once the proper authorizations are received, our team will review your request in accordance with all federal and state laws governing your privacy and medical records. Please allow 3 to 5 business days for this process.
Your Rights and Access to Personal Health Information
Pediatric Ear, Nose, and Throat, P.C. recognizes the patient’s right to access and obtain copies of their protected health information (PHI) in accordance with HIPAA laws. (Code of Federal Regulation 164) as well as Georgia Statutes.
Records for your physician
If your physician has requested that you personally request the medical records from Pediatric Ear, Nose, and Throat, P.C. please have them request the records to be sent or faxed to them. Authorization for the Release of Protected Health Information must include:
- Physician Name
- Complete Address
- Phone Number
- Fax Number
A form must be completed for each physician who may need your records.