864-458-7000 Appointment Line | 864-297-6010 Main Line
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Medical Records

Medical Records and Requests

You can request that your medical records be transferred to or from Milestone Family Medicine by completing our Medical Records Release form. Please select the appropriate form below. Please remember that privacy laws require that this form be signed by the patient requesting records, unless the patient is under 18 years of age or there is a power of attorney for an adult patient (this document will be required).

Related Documents:

 

  • Medical Records Release TO MFM
    Medical Records Release to Milestone Family Medicine. Print form, Complete all sections, Sign and Date, Send to the Provider(s)
     
  • Medical Records Release FROM MFM
    Medical Records Release from Milestone Family Medicine. Print form, Complete all sections, Sign and Date, Send to Milestone for processing.
     
  • Please be aware that there is a charge for this service. State Fees are $15 retrieval fee plus $.65 per page up to 30 pages and $.50 per page over 30 pages plus postage.

 

Privacy & Ethics

We offer our patients a sincere commitment to maintain a strict level of privacy. We will not disclose any patient information without a signed prior consent from our patient. To ensure that patients as well as staff members are aware and comply with these HIPAA regulations, we ask that each new patient reviews and signs a form stating that they have been informed of these guidelines.

Privacy Guidelines

 

Milestone Family Medicine
12 Arborland Way
Greenville, SC 29615

864-458-7000 Appointment Line
864-297-6010 Main Line
864-458-7673 Fax

Business Hours
Monday - Thursday: 8 a.m. - 5 p.m.
Friday: 8 a.m. - 11:30 a.m.
Saturday: 9 a.m. - Final Appointment
Subject To Seasonal Variability
Sunday: Closed

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Milestone Family Medicine

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