Medical Records Forms:

FMLA/Disability Form Completion:

Requesting Copies of Medical Records

UCBC is very sensitive to patient needs for copies of their medical records. The State of Georgia regulates the response times and fees to patients for copying records. The federal government regulates privacy concerns involved in copying.

UCBC has contracted with Sharecare HDS to service medical records requests.
We do not copy records in our office. If you need copies of medical records, please follow these steps.

1)   Authorization form: The law requires patients to authorize copying of Protected Health Information in writing by specifying what is to be sent and the recipient. Your authorization is good for one year.

       a)  By law you may not request copies of the records of another adult, even a      family member, unless you have a proper medical power of attorney. We accept faxed authorization forms at 706-353-4357. Blank forms are available at

       i) Please specify the records you need, based on the choices on the authorization. If you are sending records to another doctor, Sharecare HDS already knows what to send.

2)  Costs: Georgia law defines fees that are charged to you, based on the number of pages to be copied. You pay these costs in advance directly to Sharecare HDS. There are multiple ways to pay these charges, as noted on the invoice you will receive from Sharecare HDS. Copying fees apply in all cases except the following:

  •  If an UCBC physician refers you to another doctor
  • If another doctor sends a proper request that you have authorized. (The last two office visits and the most recent test results will be sent at no charge).

      a)  Fees apply to all requests for full copies of records. Please remember that   copying fees are payable to Sharecare HDS in advance. Sharecare HDS will send you an invoice.

Medical record copying fees are defined in GA Code O.C.G.A. 31-33-3 and listed below. Call Sharecare HDS for further information.

Search Fee: $25.88
Pages 1 – 20: $0.97 per page
Pages 21 – 100: $ 0.83 per page
Pages 101+: $0.66 per page
Certification Fee: $9.70

3)  Response Times: Georgia law provides 30 days to respond to copying requests. Most requests are fulfilled in less time once the fees are paid. Please do not expect the copying to be done while you wait, except in a medical emergency. Longer response times occur when the records you request are in long term storage.

Service: Call Sharecare HDS customer care at (877)391-9890 if you have any questions or problems.

To fax a request for medical records: (706) 353-2992

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