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Medical Records Request
You may obtain your medical records by following these simple steps:
1. Open and print the one page PDF form. Click here if you need to install Acrobat.
2. Fill out the form. All fields with an asterisk (*) must be filled out in order for your request to be honored.
3. Fax the form to 813-855-7540.
Click here to download the medical record request form.
If you have any questions or would like to request your records by phone, please contact our office at 813-855-7540.
Note: The form on this page is in PDF format and must be opened using Adobe Acrobat Reader. If you do not have Adobe Reader
installed on your computer, click on the logo below, download and install the application, then return to this page to download the
forms you need. Adobe Reader is free!