At Shriners Hospitals for Children, the health and safety of our patients, families, volunteers and staff is our top priority. With the evolving situation regarding COVID-19, we are closely monitoring updates from local health departments and the Centers for Disease Control and Prevention (CDC), and are actively following their recommendations.

If your child has an upcoming appointment, please contact your local Shriners Hospitals for Children location.

What to expect at Shriners Healthcare for Children  — Florida.

Telehealth Fast Track Video Visits are now available: 813-367-2105

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Medical records and insurance

Medical records and insurance

To request copies of your own medical records, or to authorize the disclosure of your medical records to another individual or third party, you will need to complete a HIPAA compliant form and submit your request in writing to the Health Information Services (HIS) department. Note: Please be sure to complete all sections when filling out the form.

Patients, legal guardians and personal representatives with legal authority to make health care decisions on behalf of the individual may obtain medical record copies by one of two methods:

  1. Completing a Patient Request for Information form: (English) (Español), or
  2. Submitting a request to release the medical record through the Shriners Hospitals for Children Patient Portal. (Note: This process does not require completion of the form listed above.)
    • If you already have access to the Shriners Hospitals for Children Patient Portal, see instructions here.
    • If you do not yet have access to the Shriners Hospitals for Children Patient Portal, contact the Shriners Hospitals for Children registration staff or care manager at this location to request an invitation.

Third parties may obtain medical record copies by submitting an Authorization for Disclosure of Health Information form that is completed and signed by the patient and/or legal guardian: (English) (Español).

Please mail completed form(s) to:

Shriners Healthcare for Children — Florida
Attention: Health Information Management Department
12502 USF Pine Drive
Tampa, FL 33612-9411

A parent or legal guardian must sign the authorization form for children younger than 18. We are required to verify your signature to release copies of medical records. It may be necessary to provide proof of legal guardianship and/or state or government-issued photo identification.

Adults who were treated at Shriners Healthcare for Children — Florida as minors must submit a legible copy of a valid state/government issued photo.

Requests for copies usually take 10 to 15 business days to process upon receipt of a completed, valid authorization form. The requested documents will be mailed to the address listed on the authorization form.

Authorization forms not completed in their entirety and/or requiring verification of signature or proof of legal guardianship will not be processed.

Please contact the health information management department at 813-975-7110 during our regular business hours: 8 a.m. to 4:30 p.m., Monday through Friday, with any questions.