Request for Medical Records
If you are interested in obtaining a copy of your medical record(s), please print and complete the Authorization For Release of Protected Health Information (PDF) .
Upon completion, you may fax, mail, or personally deliver your Authorization to the Health Information Management (HIM) Department at Fairview Park Hospital.
In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver's license, military I.D. or state I.D.), and a telephone number.
Please allow 3-5 business days for us to process your request.
Contact Us
Fairview Park Hopsital
Health Information Management (HIM) Department
200 Industrial Blvd
Dublin,GA 31021
Tel: (478) 274-3135
Fax: (478) 274-3247
Office Hours:
8:30 am to 4:30 pm Monday through Friday
For further information or assistance with the Authorization form, please call (478) 274-3337.
;){kind=link}