Requesting a Copy of Your Medical Records

 

***NOTICE: Health Information Services / Medical Records / Medical Records Release of Information will be moving to an off-site location beginning in early to mid-April 2021.  The new location will be across Hwy 32 from the hospital, next to the Georgia National Guard Armory facility, located at 1016 West Ward Street Ext. Douglas

 

Download and print the Authorization Form for Release of Medical Records and Information.

To request medical records, please complete the form below, making sure to include a daytime phone number and the patient’s signature, and mail, fax, or drop-off to:

Authorization to disclose health information

 

Coffee Regional Medical Center

Attn: Health Information Services – Release of Information

1101 Ocilla Road***

Douglas, GA 31533

 

Phone Number:  912-384-1900 and choose option # 3

Fax Number:  912-389-2105