Back to Patient Resources
Medical Records
Records release authorization.
Use this form to request release of your medical records to yourself, another provider, or another person — or to authorize Florida Surgical to receive records from an outside facility on your behalf. This is a HIPAA-required legal authorization.
🔒 Your information is protected. This form is securely hosted on a HIPAA-compliant server. All submissions are encrypted in transit and stored confidentially.
How long does it take?
Records requests are typically processed within 5 to 10 business days. We may charge a reasonable, cost-based fee for copies as permitted by law. You'll be notified once your records have been released.