Request Medical Records
Bayfront Health Seven Rivers makes medical records available to our patients. To request a copy of your medical records, complete the authorization form below and indicate the dates of treatments for which you are requesting information and the type of records that are needed.
Authorization to Use and Disclose Protected Health Information (English)
Authorization to Use and Disclose Protected Health Information (Spanish)
Bring the completed form to Health Information Management, Monday through Friday, 8 a.m. to 4 p.m. or mail or fax the form to:
Bayfront Health Seven Rivers
Health Information Management/ROI
6201 N. Suncoast Blvd.
Crystal River, FL 34428
Fax (352) 563-2815
Radiology Medical Records
Radiology images or photos are not part of your medical record. Your official records contain reports that interpret those images, tapes and photos. To request radiology images, copies of the exam and reports of procedures performed at Bayfront Health Seven Rivers, call (352) 795-8325.
Please note, there may be a charge for your radiology CD.
Frequently Asked Questions
Who may inspect medical records?
Patients or their legal representative may inspect, obtain copies of, or have copies of their medical records sent to another facility.
Where are medical records inspected?
You may only inspect records with the Health Information Department at Bayfront Health Seven Rivers.
How much does it cost to obtain copies of my medical records?
The fee for copies of your medical record is $0.37 per page and a $1.00 retrieval fee per year.
Can my medical record be mailed?
If the medical record is mailed to you, you will be charged for the mailing cost.
Can my medical record be sent to another facility or office?
Yes. All fees are waived if you request records be sent to another medical facility or office.
How long will it take to receive my copies?
Please allow five (5) working days for your request to be processed.
Can I pick up my copies?
Yes. If you plan to come to Health Information Management to pick up your request, please bring a photo ID.
Can someone else pick up my copies?
If an individual other than the patient is picking up a request, that individual will need an original signed authorization letter from the patient and a photo ID.