Requesting Medical Records
To obtain a copy of your medical record, please print and complete the attached Authorization to Disclose Health Information request form. The completed request form should be mailed to the address on the form. In most cases there is a charge for copies of your medical record. State law allows us to charge $1.00 per page. There is no charge if records are faxed or mailed directly to a verified physician’s office. The average turnaround time for a request is five (5) business days. If you have questions about the disclosure of health information, please contact the Health Information Management Department, Release of Information section at (813) 844-7533.