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Privacy Practices

Houston Healthcare is committed to protecting the privacy of all patients. We have a privacy notice in regard to patient medical information. To obtain a copy, please click on the Privacy Notice link below. If you have any questions regarding this notice, please contact Audra Cabiness, Houston Healthcare Privacy Officer, at (478) 322-5156.

Notice of Privacy Practices, English

Notice of Privacy Practices, Spanish

Request of Patient Information

The Authorization to Release Patient Information Form is utilized to request copies of your medical records or to request copies of your medical records be released to another individual or facility. This form should be returned to the facility Medical Records Department. If you require additional assistance, please contact the appropriate facility.

Houston Medical Center Health Information Management Department
(478) 542-7748

Perry Hospital Health Information Management Department
(478) 988-1619

Houston Lake Med-Stop
(478) 975-6800

Houston Lake Rehab
(478) 975-6850

Health Connections Cardiac & Pulmonary Rehab
(478) 322-5143

Lake Joy Med-Stop
(478) 975-6890

Pavilion Med-Stop
(478) 923-2843

Pavilion Rehab
(478) 923-2937

Authorization to Release Patient Information Form

Request for Amendment of Health Information

This form is utilized to submit a request for an amendment to information in your medical record.

Request for Amendment of Health Information Form