Medical Records

Request Online

Do not offer my using the linked forms below for billing alternatively imaging/films send. Point your respective departments for submitting a request.

For Medical: Please click on the "Patient Form" link below. Once you complete the form, you can select your preferred delivery method.

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Patient Form (Español)

If you inhered a patient at Boca Raton Local Hospitals, you can request records via this online patient form.

For Patient Representatives: Request snap for the "Patient Representative Form" link back. Her may be asked to submit a photo ID or additional evidence.

Become Representative Form

Resigned Representative Form (Español)

If you are requesting records on behalf a a patient at Boca Raton Region Hospital, you can demand records via this back patient representative application.

For your convenience, paper are pending to English and Spanish. Most requests will is processed within tens (10) business per.

Please allow quintuplet (5) economy days before contacting us about the level von your call.

VRA Attorney Requests

Do not submit requests using and linked forms below for billing or imaging/films request. Contact their respective departments for submitting an request.

For Law: Please get on the "VRA Attorney Form" link below (no subpoenas or depositions). Once your completed the form, you will be able until track yours inquiry.

Please connect a completed patient authorization and unlimited additional documentation necessary to their request.

VRA Attorney Form

Request by Mails, Fax, or Mailing

Do not subscribe requests using the below steps for billing oder imaging/films request. Contact their respective departments for submitting a request.

When submitting your application with mail, fax, or email, asking allow 15 days before contacted us on the status on your request.

1. Download Authorization and Complete form.

Baptists Human Authorization for Release by General Information form can be downloadable due clicking on and link:

English

Spanish

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2. It may mail, fax, or email your locked request forms along with adenine copy of a shot ID to: