Patient Information Disclosure

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Patients & Families

Release of Medical Records

Paper copies of medical records may be released upon receipt of written authorization of patients over the age of 18 or a legal guardian. Once authorization is received, it may take up to 10 days to process your request. Behavioral health records, by state law, require physician approval prior to release; please allow an additional 3-4 business days for these requests to be processed.

There is a charge to obtain copies of medical records. If requested for private use by patients or guardians, the charge is $0.84 for the first page, then $0.55 for each additional page, plus tax and postage. If the records are needed for continuing care, there is no charge to the patient when records are sent directly to your physician or the facility providing treatment.

If records are needed for treatment or for an appointment within the next 48-72 hours, physicians can request records by fax when you arrive in his/her office for treatment. Records can be faxed to the physician’s office at no charge to the patient.

Records Request Forms and Contact Information

How to obtain copies of medical records:

  1. Print and fill out the request form for the facility you need records from.
  2. Mail or bring in the completed request form to the facility’s Health Information Management office. Some facilities also allow faxing of forms.
  3. Records will be gathered and mailed to the requested address with a bill for any applicable charges.

Download the form you need below. To speak with someone about medical records, give one of our Health Information Management departments a call.

Location Phone Number Records Request Form
Florida Hospital Altamonte (407) 303-9175 Download Form
Florida Hospital Apopka (407) 303-9175 Download Form
Florida Hospital Carrollwood (813) 615-7200 Download Form
Florida Hospital Celebration Health (407) 303-9175 Download Form
Florida Hospital for Children (407) 303-9175 Download Form
Florida Hospital at Connerton Long Term Acute Care (813) 903 3733 Download Form
Florida Hospital DeLand (386) 943-4845 Download Form
Florida Hospital East Orlando (407) 303-9175 Download Form
Florida Hospital Fish Memorial (386) 917-5030 Download Form
Florida Hospital Flagler (386) 586-4340 Download Form
Florida Hospital Heartland Division (863) 402-3255 Download Form
Florida Hospital Kissimmee (407) 303-9175 Download Form
Florida Hospital Lake Placid (863) 699-4173 Download Form
Florida Hospital Memorial Medical Center (386) 231-3066 Download Form
Florida Hospital North Pinellas (727) 942-5024 Please Call
Florida Hospital Oceanside (386) 231-3066 Download Form
Florida Hospital Orlando (407) 303-9175 Download Form
Florida Hospital Pepin Heart Institute (813) 615-7292 Download Form
Florida Hospital Tampa (813) 615-7292 Download Form
Florida Hospital Waterman (352) 253- 3327 Please Call
Florida Hospital Wauchula (863) 767-8377 Download Form
Florida Hospital Wesley Chapel (813) 929-5047 Download Form
Winter Park Memorial Hospital (407) 303-9175 Download Form
Florida Hospital Zephyrhills (813) 788-0411 Download Form