Request a Medical Record

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For information requesting proxy access to a family member's Memorial MyChart health information please follow this link.

To obtain a copy of a medical record from Memorial Healthcare System, you must complete and submit the Authorization for Release of Confidential Medical Records Form. This is a Memorial policy, in accordance with federal and state laws, to protect the privacy and confidentiality of our patients' personal medical record information. Completion of this form is required  to received a copy of your medical records  or to have the medical record sent by Memorial to another party, such as a physician or other health care service provider, an insurance company or an attorney.

How to Request a Medical Record

  1. Complete the authorization form
  2. Provide a copy of a government-issued photo ID (We cannot process the request with out ID)
  3. Mail or fax it to the hospital or health care facility where the services were performed (see contact information)
  4. The hospital will respond to the request for information within two business days of receipt

Charges for Obtaining Copies of Medical Records

There may be a copy charge for medical records, as authorized by Florida law. It is often helpful to discuss your request with a representative of the hospital's Health Information Management (Medical Records) Department. You may be able to reduce the copying costs by requesting a few key documents, rather than the entire medical record. There is no charge for a patient whose records are copied if it is necessary for the continuation of medical health care service. This can be demonstrated by having the medical records sent directly to the treating physician or health care facility.

Receiving Copies of Requested Health Care Information

Medical records will be mailed or emailed. Records will not be faxed.

Birth and Death Certificates:

Contact Broward County Vital Statistics: 954-467-4413

Facility Contact Information

Memorial Regional Hospital and Joe DiMaggio Children's Hospital

Phone: 954-265-5947
Fax: 954-276-0600

Radiology Films/Reports:
Phone: 954-265-5600

Attn: Health Info. Mgt.
3501 Johnson Street
Hollywood, FL 33021

Memorial Regional Hospital South

Phone: 954-518-5437
Fax: 954-276-0600

Radiology Films/Reports:
Phone: 954-518-5155
Fax: 954-518-2250

Breast Cancer Reports:
Phone: 954-518-5200
Fax: 954-518-2204

Attn: Health Info. Mgt. 
3600 Washington Street 
Hollywood, FL 33021 

Memorial Hospital West

Phone: 954-844-7201
Fax: 954-276-0600

Radiology Films/Reports:
Phone: 954-844-7888
Fax: 954-499-3451

Attn: Health Info. Mgt.
703 N. Flamingo Rd.
Pembroke Pines, FL 33028

Memorial Hospital Miramar

Tel: 954-538-4841
Fax: 954-276-0600

Radiology Films/Reports:
Tel: 954-538-5072
Fax: 954-538-5099

Attn: Health Info. Mgt.
1901 S.W. 172nd Ave.
Miramar, FL 33029

Memorial Hospital Pembroke

Phone: 954-883-7152
Fax: 954-276-0600

Radiology Films/Reports:
Phone: 954-883-7146
Fax: 954-963-8032

Attn: Health Info. Mgt.
7800 Sheridan St.
Pembroke Pines, FL 33024