To better serve our patients and other requesters, Dothan Specialty Clinic\Affiliated Specialties has partnered with BACTES to provide Release of Information Services.
To initiate your request for a copy of medical records, please complete the Authorization for Disclosure of Health Information form. This form will be delivered promptly to a BACTES representative for processing. In order to fulfill your request, BACTES will charge a reasonable cost-based fee for copying in accordance with HIPAA and HITECH regulations. You will be responsible for these charges.
After you submit your request, you will receive notification from BACTES regarding payment options. Once payment is received, records will be mailed to you.
BACTES is committed to providing the highest levels of quality, confidentiality, and customer service. If you have any questions concerning the status of your request, please contact a BACTES Customer Care Representative.
Customer Care: 1-877-550-2083
To receive your medical records, fill-out fully and accurately the following needed forms:
Medical Records for Cancer Policy Medical Records from Rheumatology Associates of Dothan
Medical Records for Cardiology Associates Medical Records from Tri-State Urology (Dr. Pelfrey)
Medical Records from Affiliated Dermatology
Medical Records from Wiregrass Urology (Dr. M Byard\Dr. Williams)