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North broward discharge form

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The document is a Photograph & Video Release form from Broward Health, granting permission for the use and publication of an individual's image, likeness, and voice in various promotional materials without compensation. It outlines the rights waived by the signer regarding the use of their recordings, the continuous nature of the authorization, and includes a hold harmless clause. The signer acknowledges understanding the release's contents and agrees to its terms.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the fax number for Broward General Medical Center medical records?

Records Management (Medical Records) and return the completed form via fax 954-767-5135.

How can I get a copy of my medical records in Florida?

In order to obtain your medical records, you should send a written request via certified mail to the last known address of the physician (you can find a physicians last known address on their Practitioner Profile).

How do I request medical records in Broward County?

For Medical Records Requests, Please Click Here. Public Records Request. A request for public record can be emailed to PublicRecordsRequest@browardhealth.org or by calling (954) 473-7303 directly. In addition, you may submit your request via this form, online.

Who can request medical records of a deceased person in Florida?

A court appointed Personal Representative of a deceased person has the legal right to obtain the decedents records. Additionally, Florida law specifically provides that the persons next of kin has the right to obtain the decedents medical records.

How do I request medical records for Medicaid in Florida?

Email: HIPAAComplianceOffice@AHCA.MyFlorida.com You have a right to inspect or get a copy of the protected health information about you that is maintained by the Agency for Health Care Administration (Agency) within 30 days of the Agencys receipt of your request.

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