Patients & Visitors

Medical Records

Requests for medical records will be processed by HealthPort, at a Centralized Processing Center in Orange Park, Florida.

If you are interested in obtaining a copy of your medical records, please print and complete the following two forms and send them to the address or fax number below:

Authorization For Release of Protected Health Information (PDF - 66.3 KB)

Fee Acknowledgement (PDF - 109)

In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver's license, military I.D. or state I.D.), and a telephone number. Per Florida statute, there may be a charge for providing the copy (up to $1.00 per page).

Orange Park HSC
Attn: Release of Information
335 Crossing Blvd
Orange Park, FL 32073
FAX: 855-668-0697

Please allow 5-7 business days for receipt of your medical records. Should you need to check the status of your request please call 1-888-616-5721.