Request Medical Records

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PATIENTS:

You can have copies of your medical records sent by:

  • Secure email
  • Fax
  • Mail
  • Local Pick up

To request a copy of your medical records:

Patients can request copies of their medical records electronically by completing our form entitled “Authorization for Use or Disclosure of Health Information” and by presenting valid identification. This completed authorization must be dated and signed.

  1. Download this document.
  2. Complete the document.
  3. Send the document and identification:
    1. EMAIL: AGT-medicalrecords@georgetownbehavioral.comor
    2. FAX: 512-819-1124 or
    3. HAND DELIVER: to the hospital front lobby at 3101 S Austin Ave.Georgetown, TX 78626

Valid Identification:

Medical records will not be released without the requestor providing proper identification. A government issues identification is required. If you are requesting records for someone other than yourself, you must provide supporting legal documentation such as:

  • Power of Attorney
  • Advance Health Care Directive
  • Living Will
  • Executor of the Estate
  • Court order/Conservatorship appointed by the court

Medical Provider Requests for Medical Records/Results

For continuity of care purposes, please fax or email your request on your letter head and include the following information on your request:

  • Patient Name
  • Date of Birth
  • Dates of Services being requested
  • Type of reports being requested

** Your call back/contact information including:

  • Contact
  • Call back number (including extension number)
  • Fax number

Submit your requests via FAX or EMAIL

Fax: 661–837-0755

Email: AGT-medicalrecords@georgetownbehavioral.com

Processing times may vary depending on the complexity of your request, however in most cases authorizations are completed within 7-14 business days from the date of receipt.