Atrium Health Navicent Peach

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Medical Records

On your first visit to Atrium Health Navicent Peach, you will be asked to complete a "Patient Information Form." You may also complete this online prior to your first visit. At future appointments, additional information may be necessary to update your medical record. It is your responsibility to notify our office of any changes in your name, address, telephone number, marital status, health history or insurance information.

TMCPC is committed to the security of your protected health information and will use strict security standards to safeguard it. All TMCPC employees and others who are hired to work for us must adhere to strict policies and procedures to prevent any misuse of your medical information.

Our medical records and other data are kept in a secure environment that protects patient information from being accessed inappropriately by third parties. We maintain and grant access to patient information only in accordance with TMCPC security standards.

We only collect information that is necessary to provide you with the best healthcare possible. Some of this information may be given to health insurance providers and suppliers of services and their authorized billing agents, directly or through fiscal intermediaries or carriers.

In the process of treating you, we become stewards of your personal information which is maintained in your medical record.

We limit the collection and use of information about patients to that which is necessary to provide quality care and for insurance and collection purposes.

We carefully limit and control the sharing of your medical information.

You have the right to view the information contained in your medical record at any time. We will act on your request within 30 days of receipt of a written request. If for any reason the request is denied, an explanation of the denial will be provided to you in writing.

We will not release your medical records to anyone without a written medical records release signed by you, or by a parent or legal guardian, in the event the patient is a minor. We will only release information pertinent to the diagnosis or injury for which you or your child are being treated and only to the parties specified in the release of information form.

We have a privacy contract with outside companies that receive and electronically transmit your insurance claims and medical information.

Third-party researchers and others unrelated to our practice sometimes use patient information to study the effectiveness of certain medical treatments, surgical procedures, medications, or medical devices to find the best possible treatments for diseases and medical conditions. The information provided may be put together with the information from other individuals for research purposes. The information cannot be used to identify you or any other individual specifically.

If at any time you have questions or complaints regarding the privacy of your protected health information you may call our Privacy Officer or you may address your questions or concerns in writing to:

Atrium Health Navicent Peach
1960 Hwy 247 Connector

Byron , GA  31008
ATTN: Privacy Officer

Any questions or concerns regarding the privacy of your medical records will be addressed promptly. You will be notified in writing of our findings.

Acquiring Copies of Your Records

TMCPC provides medical records to its patients, and to physicians and institutions designated by patients, according to the regulations of the State of Georgia and the Health Insurance Portability and Accountability Act (HIPAA). Please follow these instructions to acquire your medical records. You may download a copy of the Authorization to Release Medical Information form here.

Download PDF:  Download Medical Records Release Form (130Kb)
  1. The authorization to release your medical records, radiology films, and/or pathology blocks and slides must be completed, signed and dated by the patient or the patient's personal representative before copies can be provided.
  2. The request for medical records will take three business days to process, upon receipt. Please allow additional days for mailing.
  3. If records are to be sent to the physician, please provide the name, address, FAX number, appointment date and time. We will forward copies of medical records directly to the patient's physician at no charge.
  4. If you are going to mail in your completed Authorization to Release Medical Information form, send it to Medical Records Department, Release of Information, Atrium Health Navicent Peach, 1960 Hwy 247 Connector, Byron, GA  31008.
  5. Medical records may be picked up at the hospital during regular business hours Monday through Friday.

If you have any questions regarding your request, please call 478-654-2280.