Medical Record – Health Information

Welcome to the Medical Record – Health Information page. In order to obtain access to your medical records, please download the appropriate form below and return it to St. Luke’s via fax or mail.

Authorization for Release of Protected Health Information (this form should be used if you are requesting your medical records for your own records or to be sent to another medical facility.)

Authorization for Release of Patient Information (this form should be used if you would like St. Luke’s to be able communicate with someone about your healthcare or appointments.)

Mailing Address
St. Luke’s Cataract & Laser Institute
Attn Medical Records
43309 US Highway 19 N
Tarpon Springs, FL 34689

Phone
800-282-9905

Fax
727-938-5606

Non-urgent requests for medical records will be processed within 30 business days.

All requests for medical records must be made via one of the forms on this page.