Request Medical Records

We make it easy to get a copy of your medical records.

Physician offices or other health care providers may request a copy of medical records.

Simply fax either a completed patient's authorization form or the request on your office letterhead to 256.894.6636 (Main Office), 256.840.3676 (South Office), or 256.571.8154 (North Office - 256.753.8154 for Arab area residents.

Patients may also request a copy of medical records by mail or in person. Patients (or legal representatives) will be required to complete required forms and submit them with a copy of a valid photo ID. Please click on the forms below to print a downloadable version. Forms are also available in the Health Information Management (Medical Records) offices.

Download the Request Forms

Request A Copy By Mail

Mail the completed forms to:

Marshall Medical Center North
8000 AL Highway 69
Guntersville, AL 35976

or

Marshall Medical Center South
2505 US Highway 431
Boaz, AL 35957

You will need to include:

  • Completed Hospital Authorization to Disclose Health Information form
  • Completed HealthPort Medical Record Reproduction Fees form
  • Completed HealthPort Electronic Record Delivery Request form (only for patients requesting electronic copy)
  • Copy of valid photo ID (driver’s license, military ID, state/government ID, passport) for the patient and/or the individual who is the recipient of the records

Request A Copy In Person

Visit the appropriate Health Information Management office located at either MMC North or MMC South. Both offices are open Monday through Friday, 8:00 a.m. – 4:30 p.m.

You will need to bring with you:

  • Completed Hospital Authorization to Disclose Health Information form
  • Completed HealthPort Medical Record Reproduction Fees form
  • Completed HealthPort Electronic Record Delivery Request form (only for patients requesting electronic copy)
  • Copy of valid photo ID (driver’s license, military ID, state/government ID, passport) for the patient and/or the individual who is the recipient of the records

Request A Copy On Behalf Of Someone Else

If the patient is under the age of 14, physically or mentally incapacitated, or deceased, a legally designated representative may complete the necessary forms on behalf of the patient and submit the request.

Patient’s representative will need:

  • Completed Hospital Authorization to Disclose Health Information form
  • Legally Authorized Representative Form(s) (guardianship, executor of estate, Power of Attorney, etc.)
  • Completed HealthPort Medical Record Reproduction Fees form
  • Completed HealthPort Electronic Record Delivery Request form (only for patients requesting electronic copy)
  • Copy of valid photo ID (driver’s license, military ID, state/government ID, passport) for the patient and/or the individual who is the recipient of the records

If the patient is 14 or older and able to complete the required forms on their own, a representative may bring the completed forms to the appropriate Health Information Management office. The Hospital Authorization To Disclose Health Information form must state that the medical records may be disclosed to the recipient receiving the medical records. Both offices are open Monday through Friday, 8 a.m. – 4:30 p.m.


Request An Itemized Statement Of Charges

Contact Patient Accounting at 256.894-6679 or 1.888.860.7453


Request Radiology CD Images and/or Film

Contact Diagnostic Imaging at 256.571.8130 (North - 256.753.8130 for Arab area residents) or 256.840.3480 (South)


Birth Certificates

The birth certificate is a legal document that will follow your child throughout his or her life. It contains information about the child, mother and father. The original birth certificate also contains health information used for statistical purposes to improve the health of children and pregnant women in Alabama. This confidential information will not be included on the certified copy of the birth certificate.

Naming Your Child

You may give your child any name you wish. Traditionally, children born to married parents have the same last name as their father. However, a child can have the mother's surname, a hyphenated name combining the mother's surname and father's surname or any other name that the parents wish. Be sure your child's name is entered on the birth certificate exactly as you want. Because it is a legal document, court action may be required to change information on the birth certificate.

Listing of father on the birth certificate when parents are unmarried

If the child's parents are unmarried, the father can only be listed on the birth certificate if he acknowledges paternity of the child. To acknowledge paternity, the Acknowledgement of Paternity Form must be completed and signed by both parents in the presence of a notary. The hospital birth certificate representative can provide the form and notary services. Each parent must show a valid photo ID (driver's license, school ID, passport, military ID, state/government ID).

If you do not wish to acknowledge paternity during your hospital stay, an Acknowledgement of Paternity can be submitted any time prior to the child's 19th birthday by contacting the Department of Human Resources county office or the Center for Health Statistics, P.O. Box 5625, Montgomery, Alabama 36103-5625.

How to obtain a certified copy of your child's birth certificate

Before you leave the hospital, you will be given a document that shows a record of the birth. This is not an official copy of the birth certificate and cannot be used for legal purposes. You will also be given an application to order an official certified copy of your child's birth certificate from the State. You may also obtain a certified copy of a birth certificate at any county health department in Alabama or go online to Alabama Department of Public Health for information on how to request a certified birth certificate from the State after you leave the hospital.

Social Security Card information

By stating on the Information on Obtaining A Social Security Number for Your Child form that you want a Social Security number issued for your child, the Social Security Administration will issue a Social Security Card for your child within a few weeks. It will be sent to the mailing address you provide. The Social Security Card will be helpful for filing your taxes, obtaining a passport for your child, admitting your child to day care programs and registering your child for school and other programs or services.

How to contact the birth certificate representative

Marshall Medical Center South
6:00 am to 10:00 pm
Monday – Friday
256.840.3425

or

Marshall Medical Center North
8:00 am to 4:30 pm
Monday – Friday
256.571.8163
(256.753.8163 for Arab area residents)

How to contact the Center for Health Statistics

Alabama Department of Public Health Center for Health Statistics P.O. Box 5625
Montgomery, Alabama 36103-5625
334.206.5418


Death Certificates

A death certificate is a legal document completed by the funeral director, medical examiner, coroner or physician who attended to the patient while in the hospital. The funeral director is responsible for completing the demographic information on the decedent. The medical examiner, coroner and/or physician is responsible for completing the medical certification section of the death certificate.

How to obtain a certified copy of a death certificate

You will not automatically receive a certified copy of a certificate of death unless you have made arrangements with the funeral director. You may obtain a certified copy of a death certificate at any county health department in Alabama once it has been filed with the State of Alabama. You may also obtain a certified copy of a death certificate by writing to the Center for Health Statistics, P.O. Box 5625, Montgomery, Alabama 36103-5625 or visit Alabama Department of Public Health for more information.

Fee for certified death certificate

The fee for a certified copy of the death certificate is $15 for one certified copy and $6 for each additional copy ordered at the same time.

How to obtain a certified copy of your child's birth certificate

Before you leave the hospital, you will be given a document that shows a record of the birth. This is not an official copy of the birth certificate and cannot be used for legal purposes. You will also be given an application to order an official certified copy of your child's birth certificate from the State. You may also obtain a certified copy of a birth certificate at any county health department in Alabama or go online to Alabama Department of Public Health for information on how to request a certified birth certificate from the State after you leave the hospital.

Changes to the medical certification section of the death certificate

The medical examiner, coroner or physician who originally signed the death certificate can make changes to the immediate cause and underlying cause of death. After the medical examiner, coroner or physician completes the Medical Certification Request Form, it is mailed to the Center for Health Statistics to amend the cause of death on the death certificate.

How to contact the death certificate representative

Marshall Medical Center South
6:00 am to 10:00 pm
Monday – Friday
256.840.3425

or

Marshall Medical Center North
8:00 am to 4:30 pm
Monday – Friday
256.571.8163
(256.753.8163 for Arab area residents)

How to contact the Center for Health Statistics

Alabama Department of Public Health Center for Health Statistics P.O. Box 5625
Montgomery, Alabama 36103-5625
(334) 206-5418

Our Vision: To provide world-class healthcare with a personal touch.