You can request a full copy of a medical record if you are a:

• parent or legal guardian of a patient under the age of 18
• patient under the age of 18 with legal rights to consent for him/herself
• patient 18 years and older
• legal guardian of a patient 18 years or older with written patient consent
• legal guardian of a patient 18 years or older who doesn't have the capacity to consent

To submit your request, simply fill out, sign, and send (via mail or fax) an Authorization to Release Form (PDF) to the location you received care. Requests are normally processed within five to seven business days.

Service Fees

There is a charge for medical record requests and it differs by state.

To request a copy of your child’s X-rays, call the location where the X-ray was performed.

Delaware

• Nemours/Alfred I. duPont Hospital for Children: (302) 651-5789

Florida

• Jacksonville: (904) 697-3716
• Orlando: (407) 650-7390
  
• Pensacola: (850) 473-4570

New Jersey

• AtlantiCare: (302) 651-5789
  

Pennsylvania

• Bryn Mawr: (302) 651-5789
  
• Nemours duPont Pediatrics, Philadelphia: (302) 651-5789
  

If you would like a physician or other individual or entity to have access to your child’s medical record, you must fill out, sign, and send (via mail or fax) an Authorization for Release Form (PDF) to the location you received care.
Identify who you’re authorizing under the “Disclose Medical Record To” section of the form.

You can revoke, or cancel, a prior authorization to access your child’s medical records by submitting your request in writing. Be sure to include the date of the release you want revoked, sign the letter, and send it (via mail or fax) to the location you received care.

Note: Nemours is not liable for prior releases made under the initial authorization.

You can restrict a person or entity from seeing certain parts of your child’s medical record, like test results, treatments, etc. To do so, you must fill out, sign, and send (via mail or fax) a Request for Restriction Form (PDF) to the location you received care. Once your provider reviews the information, we’ll contact you with the outcome of the request.

If you think there is an error on your medical record, fill out, sign, and send (via mail or fax) a Request for Amendment Form (PDF) to the location you received care. Once your provider reviews the information, we’ll contact you with the outcome of your request.