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Medical Records

If you are interested in obtaining a copy of your medical record(s), please print and complete either of the following documents.

Authorization for Release of Protected Health Information (PDF - 305 KB) PDF icon

Autorización para la Divulgación de Información de Salud Protegida (PDF - 38.3 KB) PDF icon

If you have questions regarding your STAT request or status of your medical record request, please call (866) 463-7272.

Upon completion choose one of the following options:

Fax to:

(855) 446-6008

Mail to:

HIM - Correspondence
Brandon Regional Hospital
119 Oakfield Dr
Brandon, FL 33511

Deliver in person to:

HIM - Correspondence
Brandon Regional Hospital
119 Oakfield Dr
Brandon, FL 33511

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 @ $0.25 per page. Attached is a patient fee agreement form. Please fill out this Patient Fee Agreement Form and send with the authorization. (PDF - 108 KB) PDF icon

Please allow 7 - 10 business days for us to process your request.

Contact Us

HIM - Correspondence
Brandon Regional Hospital
119 Oakfield Dr
Brandon, FL 33511
Phone: (813) 681-5551, ext. 2699
Fax: (813) 571-5097

Office Hours: Mon - Fri: 8:30am - 12:00pm, 1:00pm - 4:00pm

Oakfield Medical Plaza
212 S. Moon Ave
Brandon, FL 33511

For further information or assistance with the Authorization form, please call (813) 681-5551, ext 2699.