Medical Records Request

To request medical records, please print, complete and sign the Authorizations for Use and Disclosure form. Return the completed form with a copy of your ID to the location where your records are held.

Authorization for Use and Disclosure of Health Information (English)

Authorization for Use and Disclosure of Health Information (Spanish)

Clinics

North Mississippi Medical Clinics & North Mississippi Medical Center Clinics (all locations)

North Mississippi Medical Center-Tupelo (main hospital, first floor)
Address: 830 S. Gloster St., Tupelo, MS 38801
Office Hours: 8 a.m.-4:30 p.m. Monday-Friday
Phone Number: (662) 377-5008 
Fax Number: (662) 377-3338

Hospitals

Requests for records at all NMHS hospitals may be directed to:

North Mississippi Medical Center-Tupelo (main hospital, first floor)
Address: 830 S. Gloster St., Tupelo, MS 38801
Office Hours: 8 a.m.-4:30 p.m. Monday-Friday
Phone Number: (662) 377-5008
Fax Number: (662) 377-3338*

*Our fax line is for the sole use of record requests from health care providers. Requests from patients, attorneys, insurance companies or record retrieval services must be sent via mail or in person at the address above.