Your Medical Records

The FAQs below provide instructions for requesting your personal medical records from Summit Medical Group. If you have any questions, call the Summit Records Department at (865) 212-2293 or email them at records@summithealthcare.com.


Frequently Asked Questions

How may I request a copy of my medical record?

Upon completion of an Authorization For Disclosure of Medical Information form, send by faxing to 865-212-2230 or mailing to: Summit Medical Group Attn: HealthPort Medical Records 1275 Dick Lonas Rd., Suite 200 Knoxville,...

Upon completion of an Authorization For Disclosure of Medical Information form, send by faxing to 865-212-2230 or mailing to:

Summit Medical Group

Attn: HealthPort Medical Records

1275 Dick Lonas Rd., Suite 200

Knoxville, TN 37909

Who may sign the authorization?

The patient must sign providing authorization to release their medical records unless: The patient is a minor in which case their parent or legal guarding may sign. The patient is deemed mentally incompetent. Then their legal...

The patient must sign providing authorization to release their medical records unless:

  1. The patient is a minor in which case their parent or legal guarding may sign.
  2. The patient is deemed mentally incompetent. Then their legal guardian may sign the authorization along with sending a copy of the Durable Power of Attorney with the authorization.
  3. The patient is deceased in which case the executor of the estate or surviving spouse may sign the authorization. Please send a copy of the death certificate with the signed authorization.

What is the cost for a copy of my medical record?

CiOX Health CiOX is a contracted release of information vendor for Summit Medical Group in health information management services. Below are the standard fees for producing a copy of your medical records by CiOX. Fee for...

CiOX Health

CiOX is a contracted release of information vendor for Summit Medical Group in health information management services. Below are the standard fees for producing a copy of your medical records by CiOX.

Fee for Patients

Electronic record delivered paper

The charge will be $0.90 flat fee plus $0.05 per page for supplies

Example: 20 pages ER visit stored electronically x $0.05 per page for supplies = $1.00

Flat fee = $0.90, so total would be $1.90


Electronic record delivered electronically

(CD, USB, website/download portal) - The charge will be $6.50.


Paper stored in paper - delivered electronically

The charge will be $0.07 per page

Example: 20 pages ER x $.07 per page, so total would be $1.40.


Records stored in paper and delivered in paper

The charge will be $0.07 per page plua $0.05 per page for labor and per page for supplies, plus postage

Example: 20 pages ER visit (paper) $.07 per page = $1.40

20 pages per page fee for supplies (x $0.05) - $1.00

So total would be $2.40


There is no charge of continuity of care if records are sent directly to your physician. You will receive an invoice in the mail and the payment can be made by 1. Credit/Debit 2. Check 3. Money order

How may my physician request a copy of my medical record?

Your doctor may call the records department at (865) 212-2293, or email a request at records@summithealthcare.com.

Your doctor may call the records department at (865) 212-2293, or email a request at records@summithealthcare.com.