Records, forms and certifications


On this page:


Health Summary

A PDF summary of your online health records, including allergies, immunizations, ongoing health conditions, medications, test results, and some procedures. Additionally, it includes changing your physician or switching to another health plan. Download your health summary.


Medical records


Disability certification

We can assist your physician in completing your Disability certification forms.

Before we can do this, you will need to:

When you have completed the steps above, email all paperwork to release-of-information@kp.org, fax all paperwork to (770) 220-3705 or mail to Kaiser Permanente Georgia, Medical Records Administration, 3200 Breckinridge Blvd, Duluth, Georgia 30096. It may take up to 10 business days to process your request.

To check the status of your request, contact Medical Records Administration at (770) 220-3870.


Family Medical Leave Act (FMLA) medical certification

If medically appropriate, a medical certification can be submitted to an employer to determine FMLA eligibility.

Complete and submit this request to your doctor to certify your serious health condition(s). Your doctor will review your information to determine the appropriate timeframe requested for certification and may contact you for further information. Request FMLA medical certification

Alternatively, you can also:

When you have completed the steps above, email all paperwork to release-of-information@kp.org, fax all paperwork to (770) 220-3705 or mail to Kaiser Permanente Georgia, Medical Records Administration, 3200 Breckinridge Blvd, Duluth, Georgia 30096. It may take up to 10 business days to process your request.

To check the status of your request, contact Medical Records Administration at (770) 220-3870.


Immunization record

Request Family Medical Leave Act physician certification of a serious chronic health condition. Your record of immunization can be used for school, camp, or other needs.


My Requests

Track your requests for Medical Records, Family and Medical
Leave Act (FMLA) Medical Certification requests


Third-party requests

We can assist you with form completion or certifications that need to be sent to a third party (such as an employer, school, or social service).

Before we can do this, you will need to:

Note: Intent to pay form is not required on form completion requests.

  • Complete any required section(s) of the form prior to submission.

Some requests are subject to a fee. We will call and notify you of the cost, as payment is required before records are released.

When you have completed the steps above, email all paperwork to release-of-information@kp.org, fax all paperwork to (770) 220-3705 or mail to Kaiser Permanente Georgia, Medical Records Administration, 3200 Breckinridge Blvd, Duluth, Georgia 30096. It may take up to 10 business days to process your request.

To check the status of your request, contact Medical Records Administration at (770) 220-3870.


Insurance

We can assist you with form completion or records for insurance purposes (such as coverage applications, military records, and more).

Before we can do this, you will need to:

Some requests are subject to a fee. We will call and notify you of the cost, as payment is required before records are released.

When you have completed the steps above, email all paperwork to release-of-information@kp.org, fax all paperwork to (770) 220-3705 or mail to Kaiser Permanente Georgia, Medical Records Administration, 3200 Breckinridge Blvd, Duluth, Georgia 30096. It may take up to 10 business days to process your request.

To check the status of your request, contact Medical Records Administration at (770) 220-3870.


Other forms

We can assist you with forms for many needs, including assisted living, paid family leave, employment, and more.

Before we can do this, you will need to:

Some requests are subject to a fee. We will call and notify you of the cost, as payment is required before records are released.

When you have completed the steps above, email all paperwork to release-of-information@kp.org, fax all paperwork to (770) 220-3705 or mail to Kaiser Permanente Georgia, Medical Records Administration, 3200 Breckinridge Blvd, Duluth, Georgia 30096. It may take up to 10 business days to process your request.

To check the status of your request, contact Medical Records Administration at (770) 220-3870.