Premier is happy to provide you with a copy of your medical records and/or x-ray/MRI images. However, we want you to know that there may be a charge for duplicating your medical records. The State of Tennessee regulates fees for copying records. Currently, the established fee for copies is $20.00 for the first five pages and $.50 for each additional page. The fee to copy workers' compensation records is $10.00 for the first twenty pages and $.25 for each additional page. Postage fees apply for records sent by mail. There is no charge for faxing records to another physician as part of your continued medical care; however, you will need to give us that physician's office fax number.

Please tell us if you need copies of your x-rays and/or MRI images. The fee for copying x-rays and/or MRI images to a compact disc (CD) is $5.00 per CD.

To protect your privacy, you MUST submit a signed Medical Release Authorizaton form ("HIPAA Patient Authorization Form"). For your convenience, you may download and print the form below. Please send the completed and signed authorization form by mail or fax. If you pick up your records in person, be prepared to show your photo ID.

To download the Medical Release Authorization form ("HIPAA Patient Authorization form"), click here:  HIPAA Patient Authorization Form

Our Medical Records Department will process your request in the order received, which may take up to ten days. If fees apply, a Medical Records Department Representative will contact you. For your convenience, we offer an option to pay over the telephone with a debit or credit card.

Medical Record Department Representatives: