Complete ALL sections of the Authorization to Disclose Confidential Information Form (DH3203):

• Authorization to Disclose Confidential Information Form - English 
• Authorization to Disclose Confidential Information Form - Spanish

Mail or hand deliver the completed form to our office located at 807 West Church St., Orlando, FL 32805.

If mailing, be sure to include a copy of your valid photo identification (i.e., valid driver license, passport, etc.) with the completed DH3203 form requesting your medical records. 

This information for the Florida Department of Health in Orange County clients only. If you received health service from another county Health Department (for example: Seminole) we will not have access to those records. You will need to contact the county in which you received your services.

We are able to access all records within the FloridaShots system regardless of the Health Department or provider.

We cannot request records from another Florida Health Department location on your behalf. We cannot request records from another provider or any other state agency or your behalf.

Yes, we charge a fee for a patient or patient’s representative that requests records (paper) to take to a provider, or for personal use, such as for attorneys, insurance companies, workman’s compensation claims, residency requirements, or disability claims.

Copies of records are charged at $1 per printed page for the first 25 pages, then $0.25 for each additional printed page. Records are printed one sided.

Immunization forms – Clinical Record (687) costs $15 per copy. The immunization form needed for school admittance (680) or religious exemption will only be provided through the immunization clinic.

• There is no fee for records that are sent directly to a health care provider.
• There is no fee for records that are requested by Medicare or other public assistance programs.
• There is no fee for records that are sent electronically to the client’s Florida Department of Health patient portal account.
• We accept cash, credit cards, or money orders. We do not accept personal checks.

We can mail your medical records to the address you specify on the authorization form, or you can arrange to pick them up 8 a.m. to 5 p.m., Monday–Friday at 807 West Church St., Orlando, FL 32805.

For mailed records, once we have a count of the number of pages for your record, we will notify you of the charge.  We can take a credit card payment over the phone, or you can mail a money order (we do not accept personal checks). Once payment is made/received the records will be printed and sent.

If you are unable to pick up your records, you may send a representative. They must have the following items:

• A notarized letter from you stating that they have permission to pick up the records on your behalf
• A copy of your valid picture ID (e.g., valid driver license, passport, etc.)
• Their valid picture ID (e.g.., valid driver license, passport, etc.)

We will only fax medical records only to another health care provider or facility.

Requests are generally honored in 5-10 business days. In exceptional circumstances, it may take up to 15 days.

If the records were used by the Department to assist in treating the patient, they can be re-released. Records from an outside facility can also be re-released if requested by a court order.

The authorization form expires one year from the date it is signed unless the requestor enters an earlier date on the form.

Yes, you can review your records. Contact Medical Records at 407-858-1436 to schedule an appointment. Medical Records staff will not be able to answer clinical questions. If you have clinical questions, please let us know when you schedule the appointment so we can try to reach the appropriate clinical staff.

No, we cannot send records via email.

The Notice of Privacy Practices explains how health care providers may use patient information. The notice is posted in health department facilities and is available at customer service counters. 

Download a copy:

• Notice of Privacy Practice - English
• Notice of Privacy Practice - Spanish

The Department can only provide electronic copies of records to a patient if they have a Florida Department of Health (DOH) patient portal account. This feature is offered to patients that have received services with the Department.

Please note that if the patient did not receive services at the Florida Department of Health in Orange County, we will be unable to electronically transmit those records.

Please contact the Florida Department of Health in the county in which you had services to have them send the records. You will need to have a patient portal account in that county.

For example, DOH-Orange cannot send you records created/used in DOH-Seminole.

Records for Minors: Only the parent or legal guardian (with legal proof) can sign for the release of a minor’s medical information.  A note from a parent giving temporary guardianship to another person will not suffice as legal guardianship.

• Exception: Only the client, even if a minor, can sign for the release of their own records pertaining to Family Planning, HIV or STD (valid picture ID required).

Records for Adults: Only the client can sign for the release of their own medical information.  Your spouse, child, friend, parent, or significant other will not be given access to your information.

• Exception: Only with a valid legal durable power of attorney (which covers access to someone’s medical care/information) or medical surrogacy documents can another adult access your medical information.

For information about public records requests, visit the Florida Department of Health website.

Medical Records Department Hours:

Monday through Friday, 8 a.m. - 5 p.m.

Medical Records Department Location:

807 West Church St.,
Orlando, FL 32805

Medical Records Department Contact Phone Number:

407-858-1436