Medical Records
Your medical record is an important part of your health care experience. It serves as a basis for planning your treatment, a means of communication for the professionals contributing to your care, legal documentation describing the care you received, verification of services and treatment covered by your insurance, and basic data for health research and education.
The information found in medical records is confidential. Patients confide in their physicians because they are assured of this confidentiality and might not share the necessary personal information if this privilege did not exist. Health care workers are mandated by law and by professional standards to protect patient confidentiality. There are also state and federal laws to protect information related to specific diagnoses such as psychiatric/psychological, treatment of substance abuse (drugs and alcohol), and AIDS/HIV. By Florida law, medical records must be retained for a minimum of eight years. Some records are retained longer.
Making a Request for your Medical Records
You have several options to request your records:
- If you would like us to prepare your records to be picked up, sent to your doctor, burned to CD or mailed to your address, you can download, print and complete the Authorization for Release of Information form and send it to the Health Information Management Department.
- If you would like to obtain copies of your medical records in person, the Authorization for Release of Information form is also available in the Health Information Management Office in the hospital Clinical Center.
Making a Request to Amend your Medical Records
- You have the option to request an amendment to your medical records: You can download, print and complete the Request for Amendment of Medical Record form and send it to the Health Information Management Department. The form is also available in the Health Information Management Office located in the basement of the Hospital Clinical Center.
- Please include the medical record document to be amended and indicate the location of your specific discrepancy, such as the date of the visit, the physician’s progress note and any other specifics.
The Federal regulation allows up to 60 days to review and respond to your request for an Amendment in writing via mail.
Right to See and Obtain Copies of Your Health Information
Your records are available after your discharge and completion of care. You may request copies Monday through Friday from 8:30 a.m. to 5:00 p.m. EST.
Although your record is the physical property of the hospital, you or your legal representative control the release of the information contained in the record. To view or obtain a copy your health information, you must submit your request in writing to Health Information Management. This usually includes medical and billing records, and excludes psychotherapy notes.
In general, you must give consent for anyone, other than a member of your health care team, to receive or have access to your medical record. However, by law, your records may be disclosed without your consent under certain circumstances, such as in response to a subpoena or court order, to certain government and regulatory bodies, to someone who holds your power of attorney, to someone you have designated as your health care surrogate, to another health care provider for continued care, and to your health care insurer to obtain reimbursement for your care. We are required by law to maintain the privacy and security of your medical record. We will not use or share your information other than as described in our Joint Notice of Privacy Practices unless you tell us we can in writing. If you give us permission to share the information, you may change that decision at any time.
By law, only an adult patient, age 18 or older, or a legally designated representative has the authority to release the information contained in a patient’s medical record, regardless of who is paying the bills. Legally designated representatives include court-appointed guardians or others with power of attorney for the patient. For children under age 18, only a parent or court appointed guardian may authorize release of medical information; however, if the minor is emancipated, they can request their own records.
When the status of an deceased patient has been verified, the next of kin or legally designated representative of the estate, whose identity must be verified, may request the deceased patient’s records. By Florida law, medical records must be retained for a minimum of seven years.
By law, we are permitted 30 days to respond to your request, unless an extension has been granted; however, we strive to provide a copy of your health information usually within seven days of your request.
We may charge a fee for the cost of copying, mailing and other supplies associated with your request.
Contact Health Information Management
If you have any questions, please contact the Health Information Management Department:
Phone: (904) 244-2596 or (904) 244-2597
Fax: (904) 244-3165 or (904) 244-3360