Sister Emmanuel Hospital will close on December 1, 2018. Mercy Hospital will be the active custodian of the hospital’s medical records effective immediately. All past patients may obtain copies of their medical records by calling Mercy Hospital’s Medical Record Department at (305) 285-2111. Medical Records Release forms are available on the Mercy Hospital website, or by clicking on the links, below.
Download Forms
Authorization For Release of Protected Health Information- English
Authorization For Release of Protected Health Information- Spanish
You may also request your medical records by calling (866) 463-7272
Upon completion, please mail your Authorization to:
Tampa HCA Shared Service Center
HIM Shared Services- Centralized Release of Information
6451 126th Avenue North
Largo, FL 33773
Phone: (866) 463-7272
Fax: (855) 446-6008
Email
In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver's license, military I.D. or state I.D.), and a telephone number.
For all Insurance, Attorney, Disability and Third Party Requests, please visit the Mercy Medical Records page.