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Full service behavioral health care
for adults, children & adolescents

Intensive Care Management | Psychiatric Services | Counseling Services

Records Request

For Release of Records

To request your medical records, please complete the AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION form requesting your medical records. Click here to access the form for all Middle Tennessee Offices. Click here to access the form for Chattanooga.

The release must be completed and signed by you, parent/guardian, conservator or other legal representative of the individual whose records are being requested. If you are a legal representative, the legal document appointing you must also be presented with your request, unless it is on file with the agency.

Requests for medical records can be submitted at any MHC office. You may also request records by mail or fax by sending the completed release, a copy of your photo identification and what information you are specifically requesting to:

Mental Health Cooperative
Attn: Medical Records
275 Cumberland Bend
Nashville, TN 37228
Fax: 615-743- 1502

Requests are processed in the order received and within 7-10 business days.

If you have questions regarding how to complete the release, please call our office at 615-743-1541.  Mental Health Cooperative does not release medical records over the Internet.

 

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