Medical Records

Request Online

Do not submit requests using the linked forms below for billing or imaging/films request. Contact their respective departments for submitting a request.

For Patients: Please click on the "Patient Form" link below. Once you complete the form, you can select your preferred delivery method.

Patient Form

Patient Form (Español)

If you were a patient at Boca Raton Regional Hospital, you can request records via this online patient form.

For Patient Representatives: Please click on the "Patient Representative Form" link below. You may be asked to submit a photo ID or additional documentation.

Patient Representative Form

Patient Representative Form (Español)

If you are requesting records on behalf of a patient at Boca Raton Regional Hospital, you can request records via this online patient representative form.

For your convenience, forms are provided in English and Spanish. Most requests will be processed within ten (10) business days.

Please allow five (5) business days before contacting us about the status of your request.

VRA Attorney Requests

Do not submit requests using the linked forms below for billing or imaging/films request. Contact their respective departments for submitting a request.

For Attorneys: Please click on the "VRA Attorney Form" link below (no subpoenas or depositions). Once you complete the form, you will be able to track your request.

Please attach a completed patient authorization and any additional documentation necessary to your request.

VRA Attorney Form

Request by Mail, Fax, or Email

Do not submit requests using the below steps for billing or imaging/films request. Contact their respective departments for submitting a request.

When submitting your application by mail, fax, or email, please allow 15 days before contacting us on the status of your request.

1. Download Authorization and Complete form.

Baptist Health Authorization for Release of Health Information form can be downloaded by clicking on the link:

English

Spanish

Creole


2. You may mail, fax, or email your completed request forms along with a copy of a photo ID to: