Request to Review Protected Health Information
Individuals have the right to request for review of their protected health information contained in their designated record set. A request can be made by downloading the form, fill the form out, and mail the form to the address listed above.
Request to Amend Protected Health Information
Individuals have the right to request for review of their protected health information contained in their designated record set. A request can be made by downloading the form, fill the form out, and mail the form to the address listed above. A representative from the Agency will contact you to set up an appointment for review to amend:
Mail the form to the address above or fax to the Medical Vital Records Division at 910-433-3895. An Agency representative will contact you to set up an appointment for review of amendment request.
For additional information regarding medical records, please contact our office or email Records Manager, Monica Short-Owens at 