Need to Request a Copy of Medical Records from TCPC?
To obtain records, submit a signed and dated Authorization for Use or Disclosure of Protected Health Information to the clinic. The form may be obtained at the clinic, or you can download an online release form at the link below (preferred and fastest way) and contact the office at 248-735-8272 for submission instructions:
Tri-County Pain Consultants Authorization For Release Of Medical Records Downloadable PDF
Some requests are processed at no charge to the requesting party (such as referrals for continuing care). Other requests are charged a fee, in accordance with state statutes. MediCopy bills requesting entities such as attorneys, insurance companies, etc. directly; patients are not billed for this work.
Need to Send a Copy of Medical Records TO TCPC?
New and returning patients often need to have certain medical records sent to TCPC to assist in their diagnosis and treatment. If you need your current (or previous) provider to send your records to TCPC, a request form may be obtained at the clinic, or through this link:
Release of Info/HIPAA Form TO Tri-County Pain Consultants
Do you need help with where the info should be sent? Please check with TCPC clinic staff to obtain the mailing address for where your records should be mailed.