Cobb & Douglas Public Health must assure protection of individual health information required by the laws of the state of Georgia and the HIPAA Privacy Rule.

To Request Medical Records:

In Person: When requesting a copy of medical records in person, you may pay by credit card (Visa, MasterCard, or Discover), or cash.  The Authorization for Release of Protected Health Information Form can be completed at the time of the request or printed out in advance.

By Mail:  When requesting medical information by mail, include a completedAuthorization for Release of Protected Health Information Form, copy of photo ID and money order made payable to Cobb County Board of Health. Mail request to:

Cobb County Board of Health
Attention: Medical Records Department
1650 County Services Parkway
Marietta, Georgia 30008

By Fax: Please print and complete anAuthorization for Release of Protected Health Information Form and fax to: 770-794-4365. Records will only be returned via fax to other healthcare facilities.

Fees: Complete medical record: $15.00
Copy of individual page or form (example: Immunization record): $2.00 (each)

For additional information, please call the Medical Records office at 770-514-2360.

Forms:

Authorization for Release of Protected Health Information Form