Medical Records and Birth Certificates 
 
 
 
 

Medical Records

A patient, or his/her legal representative, may review their medical records, obtain a copy of their medical records or request to have copies of their medical records sent to another facility.

To request a copy of your Medical Records

(*Note that the form below is in a PDF format. You may have difficulties opening the PDF file below if you are using Internet Explorer 6.0 and an older version of Adobe Reader. If you do not have Adobe Reader installed on your computer or need the latest version to open the attachments, click here to download Acrobat Reader for free.)

In order to protect patient privacy and confidentiality, Spalding Regional Hospital policy, in accordance with state and federal laws, requires a completed and signed written request and authorization for release of health information to be completed before records are released to anyone, including the patient.

  • Complete, sign and date the Authorization for Release of Confidential Medical Information form. You can either download and print the form by clicking here or pick up the form at the Health Information Management office at the hospital.
  • Bring the completed authorization forms to the hospital along with a picture ID for verification.

Office hours are Monday through Friday, 8 a.m to 4:30 p.m. Your request will take three to five business days to be completed. All requests for medical record copies are subject to copy charges, taxes and postage. There is a minimum fee of $10 for all requests.

Charges for obtaining copies of your Medical Records

There is no charge to request a copy of your most recent hospital visit to be sent to your physician for continued medical care. 

 Administration fee (does not apply to patients requesting copies)

$25.88 

 Per page fee pages 1-20

 $ 0.97

 Per page fee pages 21-100

 $ 0.83

 Per page fee pages 101 and above

 $ 0.66

 Notarization Fee (if applicable)

 $ 9.70

Release of Information Services Provided by Scan STAT.

Fees set by Georgia State Statue 31-33-3 (effective July 15, 2013.)

For more information regarding medical records, please call (770)229-6940, and press option 3.


Birth Certificates

To obtain a copy of your child’s birth certificate
Upon the birth of a child, you will be given a birth certificate application to complete before you leave the hospital. This form is sent to the County government to be processed and recorded. A confirmation of the birth will be mailed directly to your home within three weeks. After this time, you will need to obtain the birth certificate from the county health department. This process usually takes four to six weeks.

For questions regarding birth certificates, please call (770)229-6940, and press option 2.