Release of Information

Yes, by Florida Law (Florida Statute 395.3025) the patient does have a right to a copy of their medical record. The original medical record is owned by the hospital, but you have access to your medical record for viewing or to obtain copies with proper HIPAA compliant authorization.

You can download the Release of Information form here or you can receive a form from the Health Information Management (HIM) Department (the form is also available in Spanish and Creole). You can fax the completed form to the HIM Department at 561.955.4137, or email the completed form to ROI@brrh.com or bring it directly to the HIM Department, located at 634 Glades Road Boca Raton, FL 33431. We must have the completed form before we can release any records.

To receive a copy of your medical record, the completed Release of Information form must be signed by the patient. You must also provide proof of ID (Example: Driver's License) at the time of receiving the records. If you wish to have your spouse or significant other pick up the records, it is still required to have the patient's signature and it must specify as to whom they have designated to pick up their records. Only the designated person on the request form will be authorized to pick up the records. Your Medical Records can also be mailed to you in the following formats:

• CD-ROM
• Paper records

The Release of Information and consent must include:

• The name of the patient whose protected health information is to be disclosed;
• Name of persons whom the information is being disclosed to: hospital, doctor, and self
• Reason for the request (i.e. continued medical care, personal use, legal, etc.); and
• Signature of patient or individual that is authorized to receive the release of information and the date the form was completed.

An authorization becomes invalid if any of the following are present:

• Hospital/facility is aware expiration date has passed;
• Release form is incomplete;
• Any of the above core elements have been omitted;
• The authorization is known to have been previously revoked; and,
• Hospital/facility knows information in core elements to be false.

In most cases they will not be sent automatically. If your physician orders clinical tests, the results will be sent automatically. If you were a hospital patient and were later sent to a specialist, you should receive copies of your medical record. Each scenario may differ. We recommend you contact your physician or care provider to advise you of your medical record needs.

If the patient is incompetent, we must have a copy of the Power of Attorney with the signed release form. The patient's legal representative can sign for the patient with the required documents. If the patient is a minor (anyone under the age of 18), the parent can sign for his or her records. If the patient is deceased, we must have a copy of the letters of administration that states the name of the individual who is in charge of the estate. If we receive a court order, we must produce the record without the patient's consent.

If the patient was not deceased at Boca Raton Regional Hospital we will require a copy of the death certificate.

If you have any other circumstances and are unsure of the requirements, please contact us at 561.955.4072. We will be happy to explain what necessary paperwork is needed to expedite the process upon your arrival.

Yes, there is a charge to copy records for your own personal use. According to Florida Statute 395.3025, the hospital may charge .25 per page, plus postage if the records are mailed. Medical records on CD are available for a flat rate of $6.50.

If your physician has instructed that you obtain a copy of your radiology images and report for your appointment, please complete and sign the Imaging Release of Information form (insert new form/hyperlink here) and send that to the radiology department either via email at imaging@brrh.com OR via fax at 561-955-4165. The images will be sent via email so please be sure to CLEARLY write your email address. Please allow 2 business days for this request. Click here for important information on how your emails will be shared.

If a CD is required, Health Information Management department (HIM) will manage that request. After receiving your completed form, they will contact you for next steps. If the CD is needed immediately, please contact them directly at 561-955-4072.

In most cases, the patient care provider does not require the patient's entire medical record. Patient care providers typically need copies of the clinical documents that include the discharge summary, history and physical, consultant reports, operative reports, radiology reports, EKG reports and lab results. This collection of medical information is called a medical abstract. The medical abstract is the most commonly requested information by care providers. Please contact your care provider for advice on what information he or she may need.

Please note: On your Release of Information request, you will be asked to document the specific parts of the medical records you need. We can educate you on the different types of request, but cannot recommend the specific documents you need. It is your responsibility to contact your care provider/requestor for the types of record needed.

Boca Raton Regional Hospital policy allows the patient or family member to review the medical record only if your physician approves and documents the information in your medical record. If your physician authorizes your family member to review your medical record, we must receive a completed release of information form.

An authorized individual from the hospital (Patient Relations, Nursing Administration, Medical Records or Risk Management) must be in attendance when the records are reviewed. Patients must be made aware that the chart is incomplete and that they cannot write in the chart or take anything out of the chart. No portions of the chart are to be copied. If copies of the chart are requested, the request must be coordinated through Medical Records after discharge.

There are many circumstances in which you will be able to receive your medical record in less than five to seven days. Although we strive to provide excellent customer service and meet our turnaround time, there are circumstances that may delay processing or impede the standard turnaround time. If you have a request pending greater than the standard processing times, please contact us at 561.955.4072 for additional information:

Boca Raton Regional Hospital
Health Information Management Release of Information
Monday - Friday: 8:00am - 4:30pm

634 Glades Road
Boca Raton, FL 33431
561.955.4072 (T)
561.955.4137 (F)