Medical Records Request
Jackson Health System's Health Information Management Department maintains medical records for the benefit of the patient and as such accessibility to the record must be assured at all times. Due to the confidential nature of the Protected Health Information within the record, and the need to preserve and protect the record, accessibility for purposes of security must be restricted.
You can request a copy of your medical records by visiting the Health Information Management Department in person or by sending the request via mail. You can request a copy of your complete medical record or specific documentation. You will be charged a fee for costs related to processing your medical record requests.
To obtain your medical records by mail, print and complete the Authorization for Release of Confidential Medical Record Request form below and mail the request to:
Jackson Health System
1611 N.W. 12th Avenue
ACC West Basement, Room L129
Miami, Florida 33136-1096
Please include a copy of your driver’s license along with your request. We DO NOT accept request via fax.
Authorization for Release of Confidential Medical Records Form:
- Authorization for Release of Confidential Medical Records (English)
- Authorization for Release of Confidential Medical Records (Spanish)
- Authorization for Release of Confidential Medical Records (Creole)
To obtain your medical records in person, complete the Release of Information form on-site in the Health Information Management Department at Jackson Memorial Hospital. Health Information Management (Medical Records) is located in the basement of the ACC West Building - Room L129.
To request or amend the medical information within your medical record, complete the Amendment/Correction of Protected Health Information (PHI) form below. This request can be delivered in person or sent via mail to the following address:
Chief Privacy Officer
JHS Privacy Office
Jackson Health System
1500 N.W. 12th Avenue, Suite 102
Miami, Florida 33136
Request to Amend Medical Record Form
Copies of birth, death or other certificates can be obtained from the Miami-Dade County Office of Vital Record's website www.miamivitalrecords.com, or by calling 1-866-830-1906.
As per Florida Statute 395.3025, Jackson Health System is allowed to charge $1.00 per page for copies of medical records. Exceptions include records needed for continuity of care.
- $0.00 for initial requests
- $0.00 for pages 1-10
- $1.00 per page exceeding 10
Monday - Friday, 8 a.m. - 4:30 p.m.
- Jackson Memorial Hospital 305-585-6290
- Jackson North Medical Center: 305-654-5047
- Jackson South Community Hospital: 786-466-7070
- Jackson Memorial Hospital 305-585-5400
- Jackson North Medical Center 305-654-3157
- Jackson South Community Hospital 305-216-0864