ENG MENU Learn more about public COVID-19 vaccination and other ways Jackson is keeping you safe. HOMEPATIENT TOOLSMEDICAL RECORDS Medical Records Request Jackson Health System’s Health Information Management Department maintains medical records for the benefit of the patient and as such, accessibility to the record must be assured at all times. Overview Authorizations Due to the confidential nature of the protected health information within the record, and the need to preserve and protect the record, accessibility for purposes of security must be restricted. While COVID-19 continues to impact our community, the release of information area is closed. We are still accepting requests, and you can submit your authorization by mail, fax, or email. To view how to submit your completed form for each of our locations, view the links below. Note: You must include a copy of your driver’s license, state ID, or passport along with your request and you must also complete both sides of the form, front and back, before submitting. Jackson Memorial Jackson North Jackson South Jackson West Vital Records Copies of birth, death, or other certificates can be obtained from the Miami-Dade County Office of Vital Record’s website or by calling 1-866-830-1906. Fees As per Florida Statute 395.3025, Jackson Health System is allowed to charge $1.00 per page for copies of medical records. Exceptions include records needed for continuity of care. $0.00 for pages 1-10 $1.00 per page exceeding 10 To request or amend the medical information within your medical record, complete the Amendment/Correction of Protected Health Information (PHI) form below. This request can be sent via mail to the following address: Chief Privacy Officer JHS Privacy Office Jackson Health System 1500 N.W. 12th Avenue, Suite 102 Miami, Florida 33136 Authorization for Release or Amendment of Confidential Medical Records Forms: Authorization for Release of Confidential Medical Records (English) Authorization for Release of Confidential Medical Records (Spanish) Authorization for Release of Confidential Medical Records (Creole) Request for Amendment Correction PHI Contact by Phone 305-585-1111 Employees Other Resources Additional Links Request a Specialist Refer a Patient © 2021 Jackson Health System. All rights reserved. Terms of Service Privacy Policy