​​​


Gilbert Ghearing, M.D.

MEDICAL RECORDS RELEASE FORM

Please be sure to sign, witness, and date the release for medical records before submitting it with your payment. Cost of medical records, in accordance with Tennessee Code Annotated 63-2-102, is $20.00 for the first 5 pages, .50 for each page after the 5th page, and may include the actual cost of mailing. 


You may mail the request to 150 Timberland Drive, Livingston, TN 38570 or fax your request to 931-899-1213.


Thank you.


NOTICE:

DR. GHEARING HAS RETIRED

​AND THE MEDICAL OFFICE IS NOW CLOSED.



To request your medical records,

please download the form below.



The mailing address is
150 Timberland Drive

Livingston, TN 38570

Fax 931-899-1213