Medical Records Request

Medical Records Request/Work Comp/ FMLA/Disability Forms

Medical records


FAX: 678-669-2619


A signed Release of Medical Records is required before we can release any medical records to you or another provider. We can provide you this form in office, fax or secure email. Please note a fee may be required.

Attorneys/Work Comp

Please fax or email your signed requests. Fees WILL be required for these requests per Georgia Copy Law.

Workers Comp

For questions related to Workers comp cases, approvals or denials, please email:

FMLA/Short term disability/Long term disability

We are happy to complete these forms for you! Please note, these can NOT be done same day. We need at least 3-5 business to complete.  There is a $25 FEE that must be paid BEFORE we begin processing.  All forms need to be emailed to Our coordinator will contact you and collect payment. If you do not hear from anyone in 24 hours, please call our office.