Print and complete the consent form for release of information and mail to the appropriate hospital campus. (Faxed requests are not accepted) You may also choose to complete the consent form on-site in the Health Information Services Department of the appropriate hospital campus.
Minors: The parent or legal guardian must sign the consent for release. Legal guardians will be asked to provide legal guardianship documentation.
Patients 18+ unable to sign a consent due to physical or mental illness: Durable Healthcare Power of Attorney (or other court appointed documentation) must be provided.
Deceased: Legal representation documentation must be provided.
Charges will apply for records needed for personal use. Charges are mandated by the State of Georgia in compliance with OCGA 31-33-3. Requests received from physicians or healthcare facilities for continued care purposes will be provided to the requestor at no charge.
For requests by mail, a prepayment letter will be mailed to you within 3-5 days after receipt of your request. Copies of your medical records will be mailed to you within 3-5 days after payment is received. If you choose to visit the Health Information Services Department, information (if available) will be provided while you wait.
Northside Hospital-Atlanta (404) 851-8102
Northside Hospital-Forsyth (770) 844-3660
Northside Hospital-Cherokee (770) 720-5350