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HOSPITAL AFFILIATION
Summit Medical Center
University Medical Center

PATIENT EDUCATION
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Summit Primary Care
3939 Central Pike
Hermitage, TN 37076
PHONE: (615) 883-2331
FAX: (615) 391-1785

Summit Primary Care - Superior Care for the Entire Family: 
						Infants to Seniors.
Summit Primary Care
Superior Care for the Entire Family:
Infants to Seniors

Request Medical Records

Requests for copies of medical records will be honored on receipt of the proper signed patient release form. There are several different types of release forms depending on the intended use of the information and the recipient of the information. These different forms have been mandated by the Federal Government under the HIPAA regulations depending on the circumstances for the release of your records. The release forms protect the privacy of your medical records and make sure that we only release the information the intended recipients of your records have a need to see.

Accordingly, please call or email us, using the form below, to explain what the purpose of your request is for so that we can send you the correct form for your completion and signature. Forms from other parties that do not include the same information as our form will be rejected as being improper authorization for records release.

For your security, we prefer you personally come to our office to fill out the proper forms so we can make sure no one other than you gets your information. However, if you can't come in to our office, you can request the forms be sent to you via fax, mail, or our patient portal. In that circumstance, please complete it according to the instructions, sign it, and send it back to us with a copy of your driver's license or a photo ID that has your signature:

BY FAX:
615-391-1785

BY MAIL:
Summit Primary Care
Attn: Medical Records
3939 Central Pike
Hermitage, TN 37076

Please note:
When we receive your request, we will copy the requested information from your current electronic chart at SPC, and mail it to the provider or person you indicate on the HIPAA release form. Records are copied in the order of requests received, and if it is determined that you are responsible for paying for the copies, we will mail your records once full payment is received. Depending on the reason for the copy request we will charge a per page copying fee and postage for this service, as defined and permitted by Tennessee law.

NOTE: We do not usually keep inactive charts longer than five years, except as mandated by law.

Questions may be submitted via this link to our portal: SPC Patient Portal

If you are an existing patient and have not yet created your Portal account, please call our office, and our staff will be happy to email you an invitation for access. New patients will need to pre-register, and your portal account will be active once your registration is accepted by our office staff.

Thank you for choosing Summit Primary Care for your primary medical care.