Medical Records

Florida Department of Health in Indian River is dedicated to ensuring the privacy of protected health information while providing quality information to those we serve. The Medical Records department is responsible for providing clients, along with other requestors, copies of requested parts of the medical record/Immunization forms. Department of Health in Indian River clients may visit our office to obtain a copy of their medical record. Please review the “What you need to know” information prior to your visit.

What You Need to Know About Requesting Medical Records

What You Need to Provide:

• Your photo ID
• For records for a minor, bring guardianship paperwork (if guardian is other than parent)

Who Can Access Medical Information?

• Records for Minors: Only the parent or legal guardian (with legal proof) can sign for the release of a minor’s medical information. A note from a parent giving temporary guardianship to another person will not suffice as a legal guardianship.
  Exception: Only the client, even if a minor, can sign for the release of their own records pertaining to Family Planning, HIV or STD (picture ID required).
  
  
• Records for Adults:  Only the client can sign for the release of their own medical information. Your spouse, child, friend, parent or significant other will not be given access to your information.
  Exception: Only with legal durable power of attorney (which covers access to someone’s medical care/information) or medical surrogacy documents can another adult access your medical information
  
  
• Vaccination Records for Adults: Vaccination records are available by contacting our office and asking for your immunization history from your records. You can also request your vaccination records directly from Florida SHOTS by filling out the Florida Department of Health form – DH3203 Authorization to Disclose Confidential Information form online, electronically sign and submit it. To fill out the form online and submit, click here.
  Note: This form is for use only by individuals aged 18 years and over to request their own immunization history. DO NOT use this form to request records for another individual. Each individual is responsible for their own request. Currently, records of minors (aged 17 years and below) are not available through this request portal. Please contact your healthcare provider or local county health department to request records for minor.
  
  

Forms

• Medical Records Release Form (please print, complete and return)
  Notes: Only the client, even if a minor, can sign for the release of their own records pertaining to Family Planning, HIV or STD (picture ID required).
  Only with legal durable power of attorney (which covers access to someone’s medical care/information) or medical surrogacy documents can another adult access your medical information
  
  
• DH3203 Authorization to Disclose Confidential Information online form
  Note: This form is for use only by individuals aged 18 years and over to request their own immunization history. DO NOT use this form to request records for another individual. Each individual is responsible for their own request. Currently, records of minors (aged 17 years and below) are not available through this request portal. Please contact your healthcare provider or local county health department to request records for minor

Copy Fees: 

• Copies of immunization records are given at no charge.
  
  
• All other copies of records are charged at $1 per copy for the first 10 pages then .25 cents for each additional page up to 10 pages
  
  
• All other copies (up to 10 pages) will be given to a client when they present for copies for themselves at a charge of $1 per page.
  
  
• Records of more than 10 pages are processed and billed by a copy service company at a rate of $1 per copy for the first 10 pages then .25 cents for each additional page.