Medical Records Request
Requesting Your Records
To request medical records, please print, complete and sign the Authorizations for Use and Disclosure form. Return the completed form with a copy of your ID to the location below.
Authorizations for Use and Disclosure Forms
Return your completed Authorization for Use and Disclosure of Health Information with a copy of your ID to:
North Mississippi Medical Center-Tupelo (first floor)
- 830 South Gloster Street, Tupelo, MS 38801
- Phone: (662) 377-5008
- Fax: (662) 377-3338*
Office hours are 8 a.m.-4:30 p.m. Monday-Friday
* Our fax line is for the sole use of record request from health care providers. Requests from patients, attorneys, insurance companies or record retrieval services must be sent via mail or in person at the address above.
For Patients of NMHS-South Marion (formerly Northwest Regional Health)
Return the completed form to the Health Information Management Department at NMHS-South Marion.
- Fax: (205) 487-7968
- Mail: North Mississippi Health Services-South Marion, 1530 US Highway 43, Winfield, AL 35594
- In Person: Ask at the front desk to be directed to the HIM Department.
You must present a form of valid photo ID to verify your identification and a telephone number upon collection of records. A charge may be applied for each copy provided, under Alabama statute. Most medical records requests will be processed and completed in about 3 business days.
myConnection
myConnection is an all-in-one platform that offers a convenient and secure way to access and manage your medical records, schedule appointments, communicate with health care providers and more.
myConnection
myConnection is an all-in-one platform that offers a convenient and secure way to access and manage your medical records, schedule appointments, communicate with health care providers and more.