22
OCT
2014
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Health Information Management (HIM) is dedicated to ensuring the privacy of protected health information while providing quality information to those we serve. HIM maintains the legal medical record for all Orlando Health patients.

Our Release of Information Department is responsible for providing patients, along with other requestors, copies of requested parts of the medical record.

Orlando Health patients may visit any of the following locations to obtain a copy of their medical record:

Arnold Palmer Medical Center

83 W. Miller St.
Orlando, FL 32806

321.841.1193

Monday thru Friday
8:00am – 4:30pm

MD Anderson Cancer Center Orlando
1400 S. Orange Ave.
Orlando, FL 32806

321.841.7254

Monday thru Friday

Dr. P. Phillips Hospital

9400 Turkey Lake Rd.
Orlando, FL 32819

321.842.8235
Monday thru Friday
8:00am – 5:00pm

South Seminole Hospital

555 W. State Road 434
Longwood, FL 32750

321.842.5144

Monday thru Friday
8:00am – 4:30pm

How to obtain copies of your medical record:

  • Complete ALL sections of the Authorization to Obtain, Release or Review Protected Health Information Form
  • Mail or hand deliver the completed form to any Orlando Health facility
  • Authorizations must be signed by the patient or the patient’s legal representative.
1. If the patient is a minor (under 18 years of age), the authorization must be signed by one of the parents or legally appointed guardian (must show proof of guardianship).
     a. Emancipated minors and drug and alcohol abuse patients who are minors may sign their own authorizations.

2. If the patient has expired, the authorization must be signed by the personal representative of the estate or legal next-of-kin. If the patient did not expire at Orlando Health, the following must be presented:
     a. Proof of death, and
     b. Proof of appointment as the personal representative of the estate.

3. If the patient is unable to sign by reason of physical or mental disability, the authorization should be signed by the next-of-kin or legally appointed guardian (must show proof) and must indicate the patient’s disability.


Release Forms