Medical Release Form

Patient Request and Medical Office Request for medical records follow the steps below:

1. Complete Medical Records Form
2. Fax Medical Records Form to 678-389-4961, mail to the location of your visit or email [email protected]

Attorney and Insurance Company Request for medical records follow the steps below:

1. Fax your request to Ciox Health – 678-389-4961

Attorney and Insurance companies may follow up with Ciox Health
2. Customer Service for medical records dept. – 770-810-8857