If you are interested in obtaining a copy of your medical record(s), please print and complete the Authorization For Release of Protected Health Information. (PDF - 65 KB)
Upon completion, you may fax, mail, or personally deliver your Authorization to the Health Information Management (HIM) Department at Lawnwood Regional Medical Center.
In order to verify your identification and validate your authorization, we require that you include a legible copy of a valid photo I.D. (e.g., driver's license, military I.D. or state I.D.), and a telephone number. Per Florida statute, there may be a charge for providing the copy.
Lawnwood Regional Medical Center
Health Information Management (HIM) Department
1700 South 23rd Street
Fort Pierce, FL, 34950
Tel: (772) 468-4470
Fax: (772) 468-4510
For further information or assistance with the Authorization form, please call Tel: (772) 468-4470