Record Request

Request for Medical Records
In order to request the release of medical information, please fax your letter of request to our confidential fax at 866.279.1991.  If you would like to request the information by mail, please mail your written request or a completed authorization form to:

TriCare Counseling & Consulting, Inc.
Attn: Medical Records
731 Tilghman Dr.
Dunn, NC 28334

Your written request for your records must contain the following information:

The Patient’s Name
The Patient’s Date of Birth
The Patient’s Social Security Number
The Name and Complete Address of Where Information is to be Sent
The Dates of Service and Type of Information to be Sent
The Patient or Guardian Signature and Date
Your Name and Telephone Number Where You Can Be Reached. We will call you to verify the information on your request and let you know if there is any cost involved in processing your request.

Valid record requests will be processed within 5 – 10 business days.