Instructions For Patient Requests
To request a copy of your medical records:
- Complete the authorization Click here to download the form.
- Check and initial the appropriate boxes.
- Fill out all the information that applies to your request. Please print legibly.
- The authorization form must be signed and dated.
- Authorizations must be signed and dated in order to be processed.
- Present a valid photo ID with your request.
How do I request my medical records?
You can email, mail, or fax (see below for addresses and contact numbers) your request Attn: Health Information Management/ROI or you can request your records in person. Release of information form can be accessed here
Cleveland Clinic Indian River Hospital
Medical Records – Release of Information
1000 36th Street
Vero Beach, FL, 32960
Phone (772) 567-4311 ext. 1356
Fax (772) 563-4441
Email recordrelease@irmc.cc
Requests for Radiology images on CD – (must be picked up in person) – 3 business days. Radiology image requests must be made directly to the radiology department at (772) 567-4311 ext. 2080
Requests for Cardiology images on CD – (must be picked up in person) – 3 business days. Cardiology image requests must be sent directly to the Cardiac Catheterization Lab at (772) 567-4311 ext. 2414
Requests for Radiation Oncology records – 3 business days. Radiation Oncology requests must be sent directly to the cancer center at (772) 567- 4311 ext. 1500.
Can I receive my records via fax?
No. Due to HIPAA rules and regulations, we only fax patient medical records to other medical facilities for immediate patient care.
What are the business hours for picking up medical records?
Monday – Friday from 8:15 a.m. to 4:45 p.m.
What is the time frame to pick up records?
| Paper | Electronic | Abstract |
|---|---|---|
| 10 business days | 3 business days | CD of Radiology Images: 3 business days. Radiology image requests must be made directly to the radiology department at (772) 567-4311 ext. 2080 CD of Cardiology images: 3 business days. Cardiology image requests must be sent directly to the Cardiac Catheterization Lab at (772) 567-4311 ext. 2414 Radiation Oncology records: 3 business days. Radiation Oncology requests must be sent directly to the cancer center at (772) 567- 4311 ext. 1500. |
You can come in and request a copy of a single visit of your medical record and receive it the same day.
Is there a charge for copies of medical records?
Yes, per Federal and State Regulations, we are authorized to charge a process and handling fee up to $1.00 per page for copies of medical records plus a charge of $1.00 for each year researched (Florida Statute 395.3025). Payment may be made by cash or credit (Visa or MasterCard). You will receive an invoice of fees when you submit your request. Payment must be made prior to receiving your copies.
- There is a flat fee of $10.00 for records placed electronically on a CD. There is no additional fee for the CD.
- There is a flat fee of $10.00 for records placed on a USB Flash Drive with an additional cost of $10.00 for the USB Flash Drive.
- There is no charge for medical records if they are provided directly to your physician/healthcare provider.
Once I request my medical records, how will I receive them?
For hospital, outpatient, or physician office records requests, we can mail them to you or you can arrange to pick them up at the Medical Center address listed above during business hours. Records can be mailed to you. An invoice will be mailed to you and upon receipt of payment, records will be mailed.
If I come to the Medical Records window, can I receive copies of my records while I wait?
If you are requesting records for one particular visit, they can be provided while you wait. Multiple visits or requests for copies of entire charts may take up to 30 days to process. An invoice will be mailed to you and upon receipt of payment records will be mailed or you can pick them up.
Who can pick up my records?
Only you can pick up your records unless you authorize pick up by another person on the signed and dated authorization form. Appropriate ID must be shown before medical records can be released. Verification of identity is required.
Who can request my records?
Only you or the person/entity authorized by you to obtain records may request records?
A Guardian, Healthcare Surrogate/Proxy or Power of Attorney (POA must specifically authorize the POA to request/obtain medical records) may request copies of your medical records. A copy of the corresponding documentation and appropriate identification must be presented before records will be released. Verification of identity is required.
Can I request records on a deceased person?
Records on deceased patients can be requested by the appointed Personal Representative (executor) of the deceased’s estate, next of kin (surviving spouse, adult children, parents, or siblings). Proper documentation and identification must be provided. This may include court documentation, death certificate, and documentation providing relationship, i.e. an adult child requesting their deceased parents records must provide proof there is no surviving spouse and a birth certificate identifying patient as their parent. Verification of identity is required.
How do I request someone else’s records?
Only under certain circumstances can you request and receive someone else’s records. You must be the parent of the minor child (under 18) who is not emancipated; or have Guardianship, Power of Attorney or Health Care Surrogate/Proxy for the patient you are requesting; or provide a court order allowing you to obtain records. Documentation must be provided.
What is an Abstract of a medical record?
- Electronic Copy An electronic copy of your health record will include records created using our electronic medical record and placed on a CD or USB flash drive.
- Paper Copy If you request a paper copy of your health record it includes an abstract printed copy of your electronic medical record.
- Abstract of Medical Record An abstract is a summary of your visit that contains the pertinent information about your treatment such as discharge summary, history and physical, consultations, operative reports, lab results, diagnostic results and reports.
