Request for Medical Records
In order to request the release of medical information, please fax your request to our confidential fax at 866.279.1991. If you would like to request the information by mail, please mail to:
TriCare Counseling & Consulting, Inc.
Attn: Medical Records
317 E. Jackson Blvd.
Erwin, NC 28339
Your written request for your records must contain the following information:
The Patient’s Name
The Patient’s Date of Birth
The Name and Complete Address of Where Information is to be Sent
The Dates of Service and Type of Information to be Sent
The Patient or Guardian Signature and Date
Your Name and Telephone Number Where You Can Be Reached. We will call you to verify the information on your request and let you know if there is any cost involved in processing your request.
There are limitation as to how long we can keep your records.
Valid record requests will be processed within 15-30 business days.
In limited cases we may be able to process expedited requests.
Thank you for understanding and patience.