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Medical Records Release Form

Workstation phone and desk

Would you like to have your medical records, or your loved one’s medical records released? We work hard to guard your records, but they are indeed yours. So if you need them, we will release them how, when, and where you want us to. But it has to be your authorization to do so. Until you grant authorization to have your medical records released, we will keep them locked and secured, consistent with the most current HIPAA privacy regulations. Simply download, print, fill out, and deliver the PDF of Southeastern Primary Care Specialists’s Medical Records Release Form. Once we have verified the form, and your authorization, we will process the requested records accordingly.

Medical Release Form


How does HIPAA protect my rights?

“The HIPAA Privacy Rule provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of health information needed for patient care and other important purposes. The Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities and their business associates to use to assure the confidentiality, integrity, and availability of electronic protected health information.”

HIPAA Privacy Form