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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 - 43.3 KB)
Upon completion, you may fax, mail, or personally deliver your Authorization to the Health Information Management (HIM) Department at Largo Medical Center.
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. Per Florida statute, there may be a charge for providing the copy.
Please allow 3-5 business days for us to process your request.
Largo Medical Center - Main Campus
Contact Us
Health Information Management (HIM) Department
201 14th Street SW
Largo, FL 33770
Tel: (727) 588-5807
Office Hours:
8 am to 4:30 pm Monday through Friday
For further information or assistance with the Authorization form, please call (727) 588-5807.
Largo Medical Center - Indian Rocks Campus
Contact Us
Health Information Management (HIM) Department
2025 Indian Rocks Rd
Largo, FL 33774
Tel: (727) 586.7105
Office Hours:
8 am to 4:30 pm Monday through Friday
For further information or assistance with the Authorization form, please call Tel: (727) 586-7105
