physician search
patient portal
career opportunities
our locations
online bill pay
image

Medical Record Request

University Surgical Associates (USA) is happy to assist you in making sure your medical records file is accurate, up-to-date and complete. Please review our policies below regarding your file.

What We Need
In order to provide you with the best treatment and service possible, USA needs a complete set of all your medical records and diagnostic films (X-ray, MRICTBone Scan, etc.) from previous surgeries/treatments. If you are unable to have your medical records sent to us in time for your first appointment or are unable to bring them with you, we may need to reschedule your appointment. For more information please review the Films and X-Rays section of our site.

Requesting Your Records
If you need USA to send your medical records to another office, please click on the authorization form in the "download" dialogue box to the right, complete the form and fax to USA's Medical Records Department at (423) 757-0748. USA does NOT charge patients for the transfer of medical records and will honor all requests within 10 days of receipt.

USA's medical records request form is an interactive, PDF document that will allow you to fill it out online. Please be sure your computer has the latest version of Adobe Reader. To fill out the form online:

  • Download USA's Medical Records Request Form.
  • Save a copy of the form to your hard drive.
  • Complete the form in full.
  • Print, sign and fax to (423) 757-0748.