Request Medical Records
To receive a copy of your medical records, please print and complete this authorization form. Be sure to complete the form in it's entirety to avoid delays with processing your request. We will need a copy of your driver's license or a valid ID when you submit your request.
You may fax this information to (601) 824-8627 or mail your request to:
Health Information Management
350 Crossgates Blvd.
Brandon, MS 39042
To get the status of a request, call 1-800-560-3800. For all other concerns, you may call (601) 824-8307 and someone can assist you during our business hours, Monday - Friday, 8 a.m. to 4:30 p.m.