If you would like to obtain a copy of your medical records, images or test results, we are here to help. To ensure privacy, we require that all request forms be signed and dated by the patient or the patient’s legally authorized representative, parent or guardian.
If the patient is under psychiatric care, the supervising psychiatrist will be required to sign the form. For more information about our legal requirement to maintain the privacy of your health information, see our Patient Privacy Notice
1. Print this form below:
2. Contact the hospital department where you received care below
Baptist Jacksonville & Wolfson Children's Hospital
Health Information Management (HIM) Office
Hours: M-F 8:30 am to 5:00 pm
Call: 904.202.1169
Fax: 904.202.2233
Mammography Imaging Department / Hill Breast Center
Office: 904.202.1896*
Fax: 904.202.6520
*If you reach voice mail, please leave a detailed message. This will help us expedite your request.
Radiology & Medical Imaging Department
Adult Office: 904.202.2167
Adult Fax: 904.202.1031
Pediatric Office: 904.202.8139
Pediatric Fax: 904.202.8144
EEG Lab
Adult Office: 904.202.2167
Pediatric Office: 904.202.8280
Baptist Medical Center South
Health Information Management(HIM) Office
Hours: M-F 8:00 am to 4:30 pm
Call: 904.271.6040
Fax: 904.271.6044
Mammography Imaging Department
Office: 904.271.6180
Fax: 904.271.6655
Radiology & Medical Imaging Department
Call: 904.271.6166
Fax: 904.271.6203
Baptist Medical Center Beaches
Health Information Management(HIM) Office
Hours: M-F 8:00 am to 4:30 pm
Call: 904.627.2945
Fax: 904.627.1824
Mammography Imaging Department
Office: 904.627.1589
Fax: 904.627.1594
Radiology & Medical Imaging Department
Call: 904.627.2990
Fax: 904.627.1512
Baptist Medical Center Nassau
Health Information Management(HIM) Office
Hours: M-F 8:00 am to 4:30 pm
Call: 904.321.3602
Fax: 904.321.3615
Mammography Imaging Department
Office: 904.321.3602
Fax: 904.321.3615
Radiology & Medical Imaging Department
Call: 904.321.3541
Fax: 904.321.3725
Baptist Clay Medical Campus
Health Information Management(HIM) Office/ Patient Access Services
Hours: M-F 8:00 am to 5:00 pm
Call: 904.516.1001
Fax: 904.516.1530
Mammography Imaging Department / Hill Breast Center
Office: 904.516.1220
Fax: 904.516.1535
Radiology & Medical Imaging Department
Call: 904.516.1214
Fax: 904.516.1535