Copies

Requesting Copies of Your Personal Medical Record

Patients may request their medical records directly via MyChart. If you do not have a MyChart account, click here to request an activation code and get started. You may also obtain a copy of your medical record by printing and completing the Request for Access to Protected Health Information by Individual Patients form below. The completed request form should be mailed to the address on the form. In most cases there is a charge for copies of your medical record. You will be informed of the charge before copies are provided.

There is no charge if records are released directly to your MyChart account.

There is no charge if records are faxed or mailed directly to a verified physicians office.

The average turnaround time for a request is ten (10)  business days. If you have questions about the disclosure of health information, please contact the Health Information Management Department, Release of Information section at (813) 844-7533.

Request for Access to Protected Health Information by Individual Patients form 

Solicitud de acceso a Información Protegida de Salud por parte del paciente

Requesting Copies of Another Individual's Medical Record

Third parties must complete and submit the Authorization to Disclose Health Information form to the TGH Health Information Management department. If you have questions about the disclosure of health information, please contact the Health Information Management Department, Release of Information section at (813) 844-7533.

Amendments/Corrections

Patients may submit an amendment request via MyChart. You may also request an amendment or change to your medical record by completing a Request for Amendment/Correction of Health Information form and submitting it to the TGH Health Information Management Department.  For more information about requesting amendments/corrections to your medical record, please call (813) 844-7525.

Requesting/Revoking A Restriction

Patients may submit a request for restrictions on how your protected health information may be used and/or disclosed to carry out treatment, payment or healthcare operations by completing a Request for Restriction(s) form and submitting it to the TGH Health Information Management Department.  For more information about requesting restrictions to your protected health information, please call Release of Information at (813) 844-7533.

Patients may submit a request for revocation of a previously approved restriction by completing a Revocation of Restriction(s) form and submitting it to the TGH Health Information Management Department.  For more information about revoking restrictions to your protected health information, please call Release of Information at (813) 844-7533.