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Below you will find instructions on how to submit your forms. If you have questions about the process, either chat us via Podium found on the bottom right of your page, or contact us

To complete an online authorization form please click here

Steps For Requesting Your Medical Records

1.  Submit an authorization form online, or you may download a PDF version: 
      AUTH FORM (English) or
AUTH FORM (Español)

The PDF version of the authorization form can be submitted by the following methods:

  • Email:
  • Fax: 615.780.9866
  • Mail: MediCopy 8 City Blvd. Suite 400 Nashville, TN 37209
  • In-Person: Drop the completed form off at your doctor's office.

2.  Once received, we will begin fulfilling your request. 

Please make sure you have completed the authorization in its entirety. If any required information is left off of the authorization, this could cause a delay in the fulfillment of the request. If there is a fee associated with your request, an invoice will be sent - either as a prepayment or with your records.

3.  Records will be sent via the delivery method specified on the authorization form. 


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