If you are interested in obtaining a copy of your medical record(s), please print and complete
Authorization For Release of Protected Health Information − English (PDF - 52 KB).
Authorization For Release of Protected Health Information − Spanish (PDF - 334 KB).
Upon completion, please mail your Authorization to:
Tampa HCA Shared Service Center
Attn: HSC Release of Information
6451 126th Avenue North
Largo, FL 33773.
In order to verify your identification and validate your authorization, we require that you includea legible copy of a valid photo I.D. (e.g., driver's license, military I.D. or state I.D.), and atelephone number. Per Florida statute, there may be a charge for providing the copy.
You may also request your medical records by calling 866-463-7272.