Request a Medical Record
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To obtain a copy of a medical record from Memorial Healthcare System, you must complete and submit the Authorization for Release of Confidential Medical Records Form. This is a Memorial policy, in accordance with federal and state laws, to protect the privacy and confidentiality of our patients' personal medical record information. Completion of this form is required to received a copy of your medical records or to have the medical record sent by Memorial to another party, such as a physician or other health care service provider, an insurance company or an attorney.
How to Request a Medical Record
- Complete the authorization form
- Provide a copy of a government-issued photo ID (We cannot process the request with out ID)
- Mail, email or fax it to the hospital or health care facility where the services were performed (see contact information)
- The hospital will respond to the request for information within two business days of receipt
Charges for Obtaining Copies of Medical Records
There may be a copy charge for medical records, as authorized by Florida law. It is often helpful to discuss your request with a representative of the hospital's Health Information Management (Medical Records) Department. You may be able to reduce the copying costs by requesting a few key documents, rather than the entire medical record. There is no charge for a patient whose records are copied if it is necessary for the continuation of medical health care service. This can be demonstrated by having the medical records sent directly to the treating physician or health care facility.
Receiving Copies of Requested Health Care Information
Medical records will be mailed or emailed. Records will not be faxed.
Birth and Death Certificates:
Contact Broward County Vital Statistics: 954-467-4413
Medical Record Amendment Request
Facility Contact Information
Memorial Regional Hospital and Joe DiMaggio Children's Hospital
Attn: Health Info. Mgt.3501 Johnson Street Hollywood, FL 33021
Memorial Regional Hospital South
Breast Cancer Reports:
3600 Washington Street
Hollywood, FL 33021
Memorial Hospital West
703 N. Flamingo Rd.
Pembroke Pines, FL 33028
Memorial Hospital Miramar
1901 S.W. 172nd Ave.
Miramar, FL 33029
Memorial Hospital Pembroke
7800 Sheridan St.
Pembroke Pines, FL 33024