To request your medical record, you can download our printable Release of Information Form. Please print and fill out the form, sign it and mail it to the hospital listed below.
Please note: We must have your signature to release the records you request. To protect your confidentiality, all patients 18 years of age or older must sign the Release of Information Form. A parent or a legal guardian may sign for children under the age of 18.
If you have any additional questions, please visit our FAQ page or call the Release of Information Department at (813) 443-7079.
St. Joseph's Hospital-North
4211 VanDyke Road
Lutz, FL 33558
Fax: (813) 635-2514