Financial Assistance Application – Inpatient
Financial Assistance Application – Outpatient
Financial Assistance Application – Brooks Medical Group
Financial Assistance Application – Home Health
Financial Assistance Application – Skilled Nursing
- Bartram Crossing and Bartram Lakes Business Office: Customer Service: (904) 528-3017
- University Crossing Business Office: Customer Services: (904) 345-8325
- Home Health Business Office: Customer Service: (904) 722-1515
- Outpatient Business Office: Customer Service: 1 (800) 418-0263
- Inpatient and Medical Group Business Office: Customer Service: (904) 345-7630
We value your opinion and feedback. If you would like to share feedback on a recent stay or visit please call: (904) 345-6610.
How to Request Your Medical Records:
Brooks Rehabilitation requires a written request/completion of Authorization for Release of Health Information for the release of medical records. The release of protected Health Information is governed by Federal and State Regulations.
- A valid photo ID or Durable Power of Attorney is required for record pick up.
- The faxing of medical records is prohibited except for continuing care patient care. Records for this purpose must be faxed directly to the treating physician’s office or healthcare provider.
- Please allow 5-7 business days to process your request.
- Hours of operation: Monday through Friday from 8:00 a.m. to 4:30 p.m.
- Production fees may apply.
If you are requesting records for a patient who lacks legal capacity or is unable to sign, an authorized personal representative may sign this form. Written proof of authority should accompany the request in order to verify appropriate health information access for the following:
- Court-appointed guardian or other legally appointed representative
- Executor/administrator/attorney in fact
- Affidavit next of kin
- Power of Attorney
To request a copy of your medical records complete the Authorization for Release of Protected Health Information.
There are a few options to get your request to us:
Walk-In or Mail:
Release of Information
3901 University Blvd South
Jacksonville, FL 32216
Fax: (904) 345-7213
Questions? Call us at (904) 345-7235
To request a copy of your medical records for services provided by Halifax Health and Brooks Center for Inpatient Rehabilitation, please contact:
303 N. Clyde Morris Blvd.
Daytona Beach, FL 32114
Phone: (386) 425-4040
Fax: (386) 425-7514
Brooks Rehabilitation Hospital: For updates on visiting information during COVID-19, please visit our Brooks Rehabilitation Hospital – University Campus page.
Bartram Crossing: For updates on visiting information during COVID-19, please visit our Bartram Crossing page.
University Crossing: For updates on visiting information during COVID-19, please visit our University Crossing page.
Please report Compliance or Ethics Concerns to: (866) TELL-BHS
- Available 24 hours a Day / 7 Days a Week
- Anonymous Reporting Available
- Operated by a Third-Party Provider