To get copies of your medical records, in compliance with state and federal regulations, you must send your request in writing. Medical records can only be released with proper authorization from the patient or the patient's legally authorized representative. Please download the PDF form below and be sure to sign and date it.

1.4-A Medical Records Authorization Form English

 

How to request your records

Mail inquiries to:

Keralty Hospital

Attn:  Health Information Management

2500 SW 75th Avenue

Miami, FL 33155

 

Fax your completed and signed form to 305-675-0372

 

How to get your record

All requests will be processed within thirty (30) business days of receipt. We can send your records directly to your physician’s office, or, if you prefer, we can email/mail them directly to you. You may also pick up your medical records at Keralty Hospital once we contact you.

Consent for email comunication of patient health information

 

Cost

Fees for medical records will be charged per applicable state and federal regulations.  If applicable, a minimal fee may be charged.

 

Questions

For more information, please contact the medical records department at 305-264-5252, ext. 1705