How To Request Your Medical Records

Your medical record is an important asset and is protected by HIPPA laws. A written and signed request is required before we release any Protected Health Information (PHI). Please read our Notice of Privacy Practice to better understand our compliance with HIPPA laws. 

Step One: Complete your Request Form

Midessa Neurosurgery and Complex Spine Authorization for Release of Protected Health Information form


Step Two: Send over your Completed Request Form

Once you have completed the form, you have three delivery options:

  1. Fax the completed form to (432) 214-2400; Attention Medical Records.
  2. Mail it to our office; Attention Medical Records
  3. Drop it off  in person during normal office hours.
  4. Email to to (note that email is not a secure method for transmitting sensitive information) 

Step Three: Wait for your Medical Records

Due to High volume, it may take up to Fifteen (15) to process your request. 

We may charge a reasonable cost-based fee to provide these records.

Finally, note that there are rare occasions when we are required by law to deny the request of medical records. We usually inform you when your records are ready. If we deny access, we will inform you in writing. 

Request an Appointment

Submit an appointment request on our patient portal or contact our office on the phone at (432) 558-7000 and speak to a live patient advocate during business hours to schedule an appointment.

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