Medical records request.

How can I change my name, address or contact information?

You can contact Patient Business Services. You do not need to fill out the form to request a revision to your medical records for these changes.

How long will it take to process my request?

You should expect your request to be fulfilled in three to five business days once it’s been received.

Is there a fee for copies of my medical records?

There is not a fee for copies that are sent directly to your healthcare provider as part of your continued medical care. You may be charged a fee for copies of your medical records that are for your own files. 

Do my medical records include billing information and payments?

No, our Health Information Management Department does not have access to your billing information. Please contact Patient Business Services for those records.

Will my medical records include radiology images, such as x-rays, CT scans or MRIs?

Our Health Information Management Department can be contacted at 321.434.1435 and can provide radiology and other imaging films for these hospitals:

• Holmes Regional Medical Center
• Palm Bay Hospital
• Viera Hospital

For Cape Canaveral Hospital, please contact the Radiology Department at 321.434.1435 for your imaging records.

How can I access medical records as a third-party, such as an attorney, insurance agent, or disability benefits processor?

You need to download, complete and submit this authorization form which allows us to release protected health information. The patient must also sign this authorization form. En español — Solicitud de paciente para acceder a los registros.

Helpful forms.

Health information release form

All requests must be mailed to one of the addresses on the form. We do not accept faxed requests for this form.