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Obtaining Your Medical Records

You may request photocopies of your medical records from the Medical Records department at the hospital where you were a patient. A completed release form signed by you or by your legal guardian is required. Click on the form below. Fill it out completely and mail or fax in to the LMHS hospital you were a patient. Proper identification will be required to pick up the records.
Authorization for Release of Medical Record Information #1062

To be used when a LMHS patient is requesting that their protected health information be released to another provider entity or external requestor (requires patient signature).


 

CAPE CORAL HOSPITAL
636 Del Prado Blvd.
Cape Coral, FL 33990
Phone:239-574-0301
Fax:   239-772-6642

GULF COAST HOSPITAL
13681 Doctor's Way
Fort Myers, FL 33912
Phone:239-768-8581
Fax:  239-768-8281

HEALTHPARK MEDICAL CENTER
9981 S. HealthPark Dr.
Fort Myers, FL 33908
Phone:239-985-8700
Fax:   239-985-8740

LEE MEMORIAL HOSPITAL
2776 Cleveland Ave.
Fort Myers, FL 33901
Phone:239-334-5441
Fax:   239-336-6898

SOUTHWEST FLORIDA REGIONAL MEDICAL CENTER
2727 Winkler Ave.
Fort Myers, FL  33901
Phone: 239-939-8581
Fax:  239-939-8267

 

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