Medical Record Release Policy

To assure confidentiality of medical records for our patients, the following requirements must be adhered to:

  1. If requesting release of medical records you will need to fill out and sign an Authorization to Release Medical Records (see form below). The request MUST be mailed to Emergency Mobile Health Care, LLC. ATTN: PRIVACY OFFICER, P.O. Box 382550, Germantown, TN 38138. EMHC will not accept fax or hand delivered request for medical records, unless it is a physician, hospital, nursing home, or other medical institution currently providing care to the patient.
  2. If calling for release of medical records from a hospital, nursing home or other medical institution, someone in that facility must verify your ID and document their request in writing via fax at 901.377.1539.
  3. If you arrive at EMHC in person requesting release of medical records, Your medical records will NOT be released. All patients and/or other non healthcare providers must submit by US Mail, a request for records utilizing the form provided by EMHC, before any records will be released. IMPORTANT: THE FORM MUST BE WITNESSED AND NOTORIZED BEFORE ANY RECORDS ARE RELEASED. ONLY THE EMHC FORM WILL BE ACCEPTED FROM PATIENTS OR NON HEALTH CARE PROVIDERS FOR ANY RELEASE OF RECORDS. EMHC charges for copying of records. Please include a check in the amount of $20.00 for processing.

Please note: Medical records will be provided within 30 business days from the date of receipt, of a properly executed release of records request. EMHC stores records for a period of 10 years from the date of service, and at which time they are destroyed.

Call 901.271.5019 for any questions regarding Medical Records.

Authorization to Release Medical Records