Accessing or Requesting Copies of Your Child's Medical Records
If you need to obtain a copy of your or your child's medical record you can submit a request for release to Shriners Children's at any time by utilizing one of the following methods:
- Log in to your Patient Portal
- Complete and submit a Patient Request for Health Information form
- Email us at HDQ-HIMRequest@shrinenet.org to request a form
- Call us at 833-243-9075 to request a form
Please mail or fax completed request(s) to:
Shriners Children's - HIMS
P.O. Box 865034
Orlando, FL 32886-5034
Fax : 813-354-4521
In order to assist with prompt response and completion of your request:
- Sign and date form – Signature verification is required for processing requests
- Include a photocopy of your state or other government issued photo ID (i.e driver’s license, ID or passport) along with written request. (Note: If you do not have a state or government issued ID, please submit your request and we will contact you if additional information is necessary
Additional guidelines and requirements:
- The Patient Request for Health Information form is for patients or legal guardians to request copies of their medical records. Third party requests require an Authorization for Disclosure of Personal Health Information. Please contact us if this form is needed.
- A parent or legal guardian must sign the request form for children younger than 18.
- We are required to verify your signature to release copies of medical records and it may be necessary to provide proof of legal guardianship.
- Requests for copies may take between 7–10 business days to process upon receipt of the request. This does not include mailing time. Requests for records prior to 2004 will take additional time.
- There may be a charge for copies of your medical records.
- We are unable to accept electronically signed documents.
For questions regarding medical records, or for third party requests for medical records, please contact us at 833-243-9075.
We Understand the Unique Medical Needs of Children
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