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Authorization for Release of Medical Records

Request for copies of records from patients must be in writing. The patient must complete this authorization form and produce picture identification; or the signature on the authorization form must match the signature in the record.

The patient must state his purpose for obtaining copies of the record. A charge will be made for copies obtained for use other than continuing medical care.

Records may be released to a person designated by the patient in writing.

South Georgia Medical Center patients must obtain copies of their medical records at:

SGMC Outpatient Plaza
4280 North Valdosta Road
Valdosta, GA

Monday-Friday, 7:30am-5:00pm
Health Information Management, Release of Information, is not available at the SGMC main campus.

For more information call 229.433.8055.


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