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Requesting Medical Records

Need a copy of your medical record? Learn more about the Brooks Rehabilitation policy on obtaining your medical record.

Release of information

A patient, or his/her legal representative, may obtain a copy, or request copies of medical records be sent to another facility.

Brooks Health System requires a written request and authorization for release of health information form be completed and signed prior to releasing any documents to anyone, including the patient.

In certain cases, a patient’s physician, psychologist or social worker may also be required to approve a request prior to release.

How To Request a Copy of Your Medical Records.

  • Print and complete the Authorization for Disclosure of Health Information Form
  • The form must be completed, dated, and signed.
  • We ask that you specify what components of your medical records you wish to obtain. Often, the discharge summary, evaluation for outpatient and discharge summary, history and physical contain relevant information to suit your needs.
  • Requests must be initialed if specifically requesting/authorizing: psychiatric, care, alcohol/drug abuse, AIDS/HIV.

For mailing/pick of records from the physician practice, Brooks Outpatient Clinics, and Brooks Rehabilitation Hospital complete the authorization form then mail or fax to:

Brooks HIM OP
Release of Information
3901 University blvd S
Jacksonville, FL 32216
Fax: 904-345-7213


Hours of operation: Monday-Friday, 8:30 am -12:00 pm and 12:30 pm – 5:00 pm
Closed for holidays

If you are a physician or a hospital and needing records for the continuation of patient care after our normal business hours, please call (904) 345-7654, hours of operation: Monday-Friday, 5:00 pm- 9:00 pm.

If you have any questions regarding release of health information, please call 904-345-7235 or 904-345-7285

Additional Information:
Please allow up to 5 business days for your request to be processed. Please provide photo ID if you want to pick up records.

Release of Information Charges:
• $1 per page for copying plus postage and handling;
• $2 per page for photos if applicable;

Deposition for therapists:
• $600 per half of the day
• $1200 for a whole day

 


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