Medical Records Request Form

Medical Records & Health Information

Obtaining Your Medical Records

You may request copies of your medical records using our online form.

  • BMC is required to maintain medical records a maximum of seven years (and longer for minors).
  • Individuals seeking personal copies of their records will be charged $1 per page. Records that are requested for ongoing care are complementary.
  • To protect your medical and personal information, your signature (on a HIPAA compliant release form) and photo identification is required.
  • If records are to be picked up by someone other than the individual whose records are being requested, a representative may be designated to pick up on their behalf using this form. The representative will need to bring the fully completed HIPAA compliant signed consent, the patient’s photo identification, and their own photo identification.
  • For individuals requesting records on deceased patients or patients who have designated a Power of Attorney, (which must specify obtaining medical records), please contact our office at 850-747-6287 for additional information.

 

To request medical records using our online form, please click here [Secure form needed]. This will lead you to your Relay Health log-in and account.

Or print this form and bring it to our medical records department or mail in your request.

Medical records must be picked up in person or requests can be mailed to:

Bay Medical Center
Medical Records / Release of Information Dept.
615 North Bonita Avenue
Panama City, FL 32401

If you have additional questions, contact the department at 850-747-6287. Medical Records is located inside the Women’s and Children’s Pavilion entrance. Take the hallway to the right into the main area of the hospital and the Medical Records office is on the left.

How to obtain X-Rays and other Images

Release of Patient Imaging Procedures

  • Bay Medical physicians have direct access to their patients’ imaging procedures through the Bay Medical Center Provider Portal.
  • Physicians requesting copies of their patient procedures via CD will be delivered directly to their office by courier or U.S. Post Office.
  • Patients requesting a personal CD copy of an imaging procedure for their records, please come to Medical Records/Release of Information to complete the authorization to request a CD.
  • Copies of patient procedures are available on CD format and may be picked up.
  • There is a charge of $5 for each CD to offset reproduction cost.
  • Patients must sign an Authorization for Release of Protected Health Information form and present photo identification prior to release of the CD. Records are not accessed prior to receiving patient authorization.
  • A representative of the patient may pick-up the CD on behalf of the patient if so designated on a valid Authorization for Release of Protected Health Information form signed by the patient. The representative must present photo identification.
  • If you have any questions or need assistance, please call (850) 747-6209.

 

How to Order a Florida Birth Certificate

  • Obtaining a birth certificate from the state of Florida is now an automated process.
  • The Florida’s birth certificate is a computer certification that contains an embossed seal incorporated into the safety paper, which meets the requirements established by Homeland Security and other national and international groups.

 

Applications are accepted by mail or in person:

Bureau of Vital Statistics
1217 Pear Street
Jacksonville, FL 32202

For additional information on birth certificates, call (877) 550-7330.