Release of Medical & Billing Records

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.

Authorization for Medical & Billing Record Release
 

  • 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:
Brooks Rehabilitation
Release of Information
3901 University Blvd South
Jacksonville, FL 32216

Fax: (904) 345-7213

Email: Email a PDF of your authorization to the Release of Information Department at Brooks.ROI@brooksrehab.org.

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:

Halifax Health
HIM Department
303 N. Clyde Morris Blvd.
Daytona Beach, FL 32114
Phone: (386) 425-4040
Fax: (386) 425-7514

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