Request your records securely through MediCopy — our trusted medical records release partner
Click the "Download MediCopy PDF" button on this page to download the authorization form. Print it out and complete all required fields.
Visit medicopy.net and follow the on-screen instructions to submit your completed authorization form along with your request.
If you have questions or need assistance, call us at 901-405-0275 or reach out to either of our locations directly.
Most record requests are fulfilled within 5–10 business days after the completed authorization is received.
All record releases comply with HIPAA regulations. Your health information is handled with the highest level of security and confidentiality.
7645 Wolf River Cir, Germantown, TN
901-665-3123
7684 Airways Blvd, Southaven, MS
901-316-9807
Download and complete this form to authorize the release of your medical records from Memphis Neurology through MediCopy.
⇩ Download MediCopy PDF ↗ Go to MediCopy WebsitePDF • 187 KB • Print & complete before submitting