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Office: 535 Newnan Street Carrollton, GA 30117

Records Request

Moving?

There are many reasons why people need copies of their dental records. Perhaps you are moving and want your records for your new dentist. Alternately you may be having a medical issue and your physician may want to review your dental records to see how those may impact your medical problems.

Regardless of the reason we are more than happy to provide you with a copy of your records. The most common request we receive is for photocopied records. If that is what you want we will charge you $.50 for each page photocopied plus $30 per hour for staff time to make the copies. If you choose not to pick up your records we will also need to charge you for postage.

We can provide your records in other formats and if applicable we can provide a written summary either as an alternate for or as a supplement to the records. Regardless of what you need you may either call our office or use the e-mail form below to begin the process.

In addition, all record requests must be accompanied by a release form. You can download this form using the button below or by going to the Forms page of this website. If you are requesting records for you spouse, adult child, parent or anyone of legal age other than yourself they will need to sign the form to allow us to release their records to you. If you have any questions about this process please do not hesitate to call us at (770) 834-6663 or use the e-mail form below.

Required Form

In addition, all record requests must be accompanied by a release form. You can download this form below. If you are requesting records for you spouse, adult child, parent or anyone of legal age other than yourself they will need to sign the form to allow us to release their records to you.


If you have any questions about this process please do not hesitate to call us at (770) 834-6663 or use the e-mail form below.

Online Request



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