We are committed to keeping your Protected Health Information (PHI) private, and we are required by law to respect your confidentiality. If you’d like a copy of your medical records, please contact or visit the Medical Records Office as listed below, or you can submit your completed form to email@example.com.
Medical Records Office
Florida Medical Center
5000 West Oakland Park Blvd
Ft. Lauderdale, FL 33313
Tel: (954) 730-2830
Fax: (954) 730-2803
When you come to pick up your medical records or when you send a request to receive your medical records by fax or mail, please be sure to provide a valid government-issued picture ID such as a driver’s license, identification card, passport, or comparison of signatures documented in the medical records.
If someone other than the patient is picking up or requesting to fax or mail the records, that person needs to provide a government issued picture ID and an original signed authorization letter from the patient. There may be a charge for creating a copy of your records.
Click below to download the form:
Authorization for the Release of Medical Records