Medical Records
Release of Health Information
Campbell Clinic Orthopaedics has partnered with Sharecare to fulfill your requests for records.
Campbell Clinic Orthopaedics is committed to protecting your medical information. For information about your rights and the obligations you have regarding the use and disclosure of your medical information, please see our Notice of Privacy Practices.
If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You will be required to provide a valid email address and a government-issued ID.
If you are unable to complete the electronic form above, download and complete the paper form below. The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Please note the processing of records is faster using the online form above.
Release of Health Information Authorization Form
Records are usually available within 10 days from the time the request is received.
Only the patient, parent/legal guardian, or the patient’s legal health care representative can sign the form to release medical records. If you are requesting records on behalf of the patient or as the patient’s representative, please provide a copy of an Advance Directive/Durable Power of Attorney for healthcare/ Conservatorship.
Request Submission for Third Party Requesters
If you are an attorney, insurance company, or any other entity requesting records from our facility, please click on the link below to upload your request along with the patient’s authorization.
Request Medical Records Online
FMLA/Disability Submission for Patients and Requesters
If you are a patient, employer, or disability company requesting an FMLA or Disability form to be completed, please click on the link below to upload your blank form. Once you have submitted your form, Sharecare will contact you within 48 hours to collect payment for processing.
Submit FMLA or Disability Forms
When will my online medical record request be ready?
Your records will be ready in 3-5 business days from the receipt of your electronic request.
How do I check the status of my request?
How do I pay for my records and/or radiology images?
How do I contact Customer Service?
You may call: 858-244-1811
Or
For appointments call
901-759-3111
IF YOU ARE A PROVIDER:
Fax requests to: 833-464-5001
IF YOU ARE A PROVIDER:
Fax requests to: 833-464-5001