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Medical Record Request Form

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Battling with Drug and Alcohol Addition? Remember, you are not alone and we are here to help you!

SOLUTIONS HEALTHCARE MEDICAL RECORDS REQUEST FORM

All patient healthcare information is confidential and protected by State & Federal laws.

Solutions Healthcare and its subsidiaries (Orlando Treatment Solutions, DeLand Treatment Solutions, Palm Coast Treatment Solutions) require a completed, signed and dated Authorization for Release of Protected Health Information before healthcare records can be released to anyone, including the patient.

To ensure that Solutions Healthcare complies with federal privacy laws and regulations if anyone other than the patient, including spouses or family members are attempting to obtain medical records on the patient’s behalf, we require documentation granting legal authority or a sworn affidavit attesting to the representatives’ legal authority to obtain medical information on behalf of the patient.

HOW TO REQUEST A COPY OF YOUR MEDICAL RECORDS

Linked below is our Authorization Form for Release of Protected Health Information.

Download Authorization Form

Completed authorizations and any additional documentation that may be required can be sent to Solutions Healthcare via mail or email at the address listed below:

Solutions Healthcare
Attn: Medical Records
400 FL-434, Suite 1008
Oviedo, FL 32765

Email: medicalrecords@shc.health

NEED ADDITIONAL ASSISTANCE?

If you have questions about this process, please feel free to email our Risk Management department at admin@shc.health or call (386)-866-3600

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Areas and Cities We Serve SUD & Mental Health Treatments

  • Oviedo
  • Orlando
  • Palm Coast
  • Jacksonville
  • Port St. Lucie
  • Tampa
  • Altamonte Springs
  • Kissimmee
  • St Cloud
  • Winter Garden
  • Winter Park
  • Clermont
  • Melbourne
  • Sanford
  • Deltona
  • Lake Mary
  • Mount Dora
  • Leesburg
  • The Villages
  • Union Park
  • St. Augustine
  • Dupont
  • Port Orange
  • Ormond Beach
  • Holly Hill
  • Daytona
  • Beach
  • Edgewater
  • Oak Hill
  • Maytown
  • Eldora
  • Geneva
  • Titusville
  • Christmas
  • Port St. John
  • Port Canaveral
  • Cocoa Beach
  • Osteen
  • Satellite Beach
  • Palm Bay
  • Roseland
  • Sebastian
  • Fellsmere
  • Gifford
  • Rockledge
  • Oviedo
  • Orlando
  • Palm Coast
  • Jacksonville
  • Port St. Lucie
  • Tampa
  • Altamonte Springs
  • Kissimmee
  • St Cloud
  • Winter Garden
  • Winter Park
  • Clermont
  • Melbourne
  • Sanford
  • Deltona
  • Lake Mary
  • Mount Dora
  • Leesburg
  • The Villages
  • Union Park
  • St. Augustine
  • Dupont
  • Port Orange
  • Ormond Beach
  • Holly Hill
  • Daytona
  • Beach
  • Edgewater
  • Oak Hill
  • Maytown
  • Eldora
  • Geneva
  • Titusville
  • Christmas
  • Port St. John
  • Port Canaveral
  • Cocoa Beach
  • Osteen
  • Satellite Beach
  • Palm Bay
  • Roseland
  • Sebastian
  • Fellsmere
  • Gifford
  • Rockledge