MEDICAL RECORDS
PATIENT REQUEST

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Please download and return the following form with your original signature.
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Once we receive you HIPAA form, we will calculate your cost for the requested records within 5 to 10 business days.
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Additional fees will apply for expedited or overnight deliveries.
ATTORNEYS OR WORKER COMPENSATION REQUEST
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Charges are mandated by the State of Georgia in compliance with OCGA 31-33-3.
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Please notify us in writing via the location mentioned below. We will contact you within 5 to 10 business days with the cost of your request.
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Once we receive your payment, we will mail your requested records within 5 to 10 business days.
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Additional fees will apply for expedited or overnight deliveries.
REFERRING OR TREATING DOCTOR REQUEST
Patient Medical Records request can be accessed for referring physician offices via the following areas:
- Mail or Fax the downloaded
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If this is urgent, please fax request to (888) 802-8664, you may call 678-691-2756 to leave a detailed message.
Fax: (888) 802-8664
Email: medicalrecords@omidiagnostics.com
Mail: 12460 Crabapple Rd, Suite 202-507 Alpharetta, GA 30004
Phone: (678) 691-2756
NEW MEDICAL RECORDS CONTACT INFORMATION AS OF AUGUST 1 2019:
