At .25+ I'm not surprised you have no recollection, that's well into the alcohol toxicity range.
You don't have to request the hearing, it's just your due process for avoiding the administrative suspension of your license. You can file the request yourself, but I suspect you're not going to be very effective at the hearing without counsel. In Georgia, these hearings involve the arresting officer so a lot of the DUI lawyers will use it as a minidiscovery phase as part of the overall DUI defense.
I think you can get your restricted licensed greased at the hearing even if you do get suspended.
I'm not sure what "medical history" you are referring to, but there isn't likely to be anything the exculpates an driving with an excessive BAC like that.
I'm not a lawyer, but I did stay in a Holiday Inn Express last night.