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If you are interested in obtaining a copy of your medical record(s), please print and complete the Authorization For Release of Protected Health Information (PDF) .

Upon completion, you may fax, mail, or personally deliver your Authorization to the Health Information Management (HIM) Department at West Florida Hospital.

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.

Please allow 1-2 business days for us to process your request.

Contact Us

West Florida Hospital
Health Information Management (HIM) Department

8383 North Davis Highway
Pensacola,  FL  32514
Tel: (850) 494-6503
Fax: (850) 494-6517

Office Hours:
8 am to 4:30 pm Monday through Friday

For further information or assistance with the Authorization form, please call (850) 494-6503.