In an effort to protect our clients personal information, all clients requesting copies of medical records will need to complete a release of information form. A copy of this form can be obtained by:
- Calling 727-619-0300, Ext. 0264
- Visiting one of our locations
- Please note, although you can drop off a completed release of information form to any location listed above, medical record services are only provided at our Summit Professional location.
- Download and complete our printable Release of Information form (English I Spanish I Creole). Mail completed forms to our Summit Professional location.Please include a copy of your picture ID.
Other Services
Other health care providers can request copies of medical records by faxing a Release of Information form to 727-484-3861 (Main) or 727-861-4873. The form can also be mailed to our Summit Professional location. Non urgent requests for medical records will be processed within 7-10 business days.
The Florida Department of Health in Pasco County does not charge clients or health care providers for copies of medical records.
View our Notice of Privacy Practices (English I Spanish I Creole).