Release of Information Department
Your Medical Records
Open Monday - Friday, 8 A.M. - 4:30 P.M.
CLOSED ON HOLIDAYS
According to federal law, patients have the right to get copies of most medical records, whether they are paper copies, or electronic health records. Doctors' notes, medical test results, lab reports and billing information must be supplied to patients if they ask correctly.
The federal law that addresses medical records is called HIPAA, the Health Information Portability Accountability Act.
*Some results may be available through MyChart. Please see the MyChart Learn More page.
*Third-party requesters please see frequently asked questions for authorization submission process.
WellStar Health System Release of Information (ROI) Services
To have a copy of your medical records sent to another medical facility, or to obtain a copy for personal reasons, please complete the following steps:
- Download the WellStar Authorization for Release of Protected Health Information form, located to the right under ROI Documents.
- Print, complete and acknowledge the Authorization Form in its entirety.
- If you would like records electronically, please print and fill out the eDELIVERY REQUEST LETTER located under ROI Documents.
- Fax or Mail the Completed and Signed Authorization Form and any additional documentation to:
Please address your request to the appropriate WellStar Hospital and mail your request.
ATTN: HIM Release of Information to the corresponding address below:
WellStar Kennestone Hospital
677 Church Street
Marietta, GA 30060
WellStar Cobb Hospital
3950 Austell Road
Austell, GA 30106
WellStar Douglas Hospital
8954 Hospital Drive
Douglasville, GA 30134
WellStar Paulding Hospital
2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
WellStar Windy Hill Hospital
2540 Windy Hill Road
Marietta, GA 30067
Fax to: 770-810-4193
*There will be no charge for having your medical records sent to another medical facility if faxed to the facility only. If you want to obtain copies for any personal reasons, you will be charged a minimal fee per page.
*If there were multiple visits only fax one request, but ensure all requested Hospitals are checked on the form.
*Please ensure the authorization form is legible for verification of identity.
*Please expect a 7 - 14 business day turnaround time dependent on volume.
Records for you Own Use
If you wish to obtain medical records for you personal use we are happy to assist you in this process. The per page charge is as follows:
- Pages 1 - 20
- Pages 21 - 100
- Pages 101+
Sales tax, and postage as applicable, will be charged for medical records per Georgia Statue 45 CFR 164.524(c)(4) and O.C.G.A. 31-333.
Authorization for the Release of Protected Health Information Form
All requests for medical records must be fully completed and dated on or after the date of discharge to be processed. After the properly
executed authorization has been received, our team will review for all required elements and processes in accordance with federal and state laws
governing you privacy and medical records. Please allow 3 to 5 days for this process. For your convenience we offer delivery electronically, or
records can be mailed to the address listed on the authorization. Please see e-request form under ROI documents.
Your Rights and Access to Personal Health Information
WellStar Health System recognizes the patient's right to access and obtain copies of their protected health information (PHI) in accordance to
HIPAA laws. (Code of Federal Regulation 164) as well as Georgia Statutes. Should you require any behavioral health records, O.C.G.A. 31-33-2
requires physician approval prior to us releasing any medical records to you. Please allow an additional 3 to 4 business days for these requests
to be processed.
Records for you Physician(s)
If your physician is on staff at a WellStar Hospital he/she may access your medical records from their office without you facilitating this request.
If the office has requested that you personally request the medical records from a WellStar Health System Hospital then we can fax the records to your
physician's office at no charge to you, once you complete the authorization for the Release of Protected Health Information Form in detail ensuring the following items are included.
- Physician Name
- Complete Address
- Phone Number
- Fax Number
A form must be completed for each physician who may need your records mailed or faxed. Please note that your records will be mailed unless you
specify an appointment time and date. If specified the records will be faxed.
Insurance Requests/Attorney Requests/Disability Requests
Requests should be sent from insurance companies, attorney or Departments of Disability Determination Services and, mailed to the address on our
authorization. All charges for medical records will be billed to the requestor.
Please contact the department directly that performs that service to facilitate your request.
Who May Request Medical Records and Who Must Share Them
To request medical records, you must be the patient, or the parent or guardian of the patient for whom you seek records.
Caregivers may be able to access records if the patient has provided written permission to the provider.
The U.S. Department of Health and Human Services provides good background information for understanding who may have access to your records.
Providers are required to share any notes or records they have created themselves, or any test results for which they have copies. They are also required to share any
information provided to them about you by another doctor if that information was used for the diagnosis and/or treatment being discussed with you.
Diagnostic lab test records, for such tests as blood tests, CT scans, X-rays, mammograms or others, should be requested from the doctor who ordered them, or your primary
care physician. In most states, the lab will not provide them to you directly.
If you seek hospital records or records from any other medical facility, you will want to request them directly from that facility.
Be aware that you may be denied some records, usually related to mental health records. If a provider believes that letting you look at your medical records can endanger
your physical health, your request may be refused. They cannot deny you access just because they think you will be upset, unless they believeÃ‚ revealing the information might
lead you to physically harming yourself. If you are refused, the provider must make that clear, in writing.
How do I obtain copies of Medical Records for those other than myself?
How long will it take to process my request?
- My Child
The parent or legal guardian must sign the consent release. Legal guardians will be asked to provide documentation of legal guardianship.
- Patients who are 18 or older, but unable to sign consent due to physical/mental illness
Durable Healthcare Power of Attorney (or other court appointed documentation) must be provided.
- Patients who are deceased
The legally appointed Executer of Estate must complete the consent for release.Legal representation documentation must be provided.
Requests for copies will be processed within 15 business days; however they may take up to 30 days. Copies may be emailed or mailed to the address provided.
May I fax my request?
Yes , please fax the completed authorization and any additional paperwork to (770)810-4193.
What if I was seen at multiple facilities and need copies of records from all facilities?
Only send one authorization form. Please indicate on the form all the facilities you would like to receive records from, and the dates. You may receive your medical records electronically or by mail.
Is there a fee for obtaining my medical records?
Fees for personal records are as follows:
- Pages 1 - 20
- Pages 21 - 100
- Pages 101+
The Georgia Office of Planning and Budget has approved these fees for cost related to medical record retrieval, copying and certification effective July 1, 2004.
What if I am a third party and would like to request Medical Records?
To obtain a copy of a WellStar medical record, we require a written request and properly executed patient authorization for disclosure of protected health information.
This can be mailed to Health Information Management, Release of Information Services, at the address of appropriate WellStar Hospital. On your request letter and patient authorization
identify the hospital where patient was treated. Fax requests are only accepted from healthcare providers and patients. Our business hours are Monday through Friday, 8:30 am to 4:30 pm.