Request Medical Records

For a copy of your medical records:

  1. Download and fill out the Authorization Form. If you do not need the entire medical record, please select the abstract box.

  2. Bring that form to the nearest TOC location, or mail the form to the TOC location you were last seen at.

  3. After your request has been received, Our medical records provider (Sharcare Health Data Services), will process within 24 to 48 hours and generate an invoice (if over 20 pages)

  4. Records will be sent once payment is received. You may choose either mail or email as delivery options.

    If you need records sent directly to another healthcare provider for ongoing treatment, follow steps 1 and 2. There is no fee for records sent directly to another healthcare provider. You may choose mail or fax as the delivery options (not both).

  5. For questions about medical record requests contact (866) 641-4778.

 

Medical Record Auth Form PDF

 

 

FMLA/Disability Forms

  1. Download and fill out the Authorization Form.

  2. Attach your blank FMLA or Disability forms.

  3. Bring those forms to the nearest TOC location, or mail the form to the TOC location you were last seen at.

  4. Sharecare will contact you regarding payment (A fee of $30 per from is required prior to form completion).

  5. Once payment is received, your form(s) will be completed and sent to the recipient listed on the release.

  6. For questions about FMLA or disability forms, please contact (866) 273-4039.

 

FMLA/Disability Auth Form PDF

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