Records Requests & Release

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, email or fax) an Authorization to Release form. Requests are normally processed within 5-7 business days.

• Authorization to Release Form (PDF) English | Spanish

For personal copies of records to be sent to you via CD, fax or paper, a fee of $6.50 will apply.

We can upload a copy of your personal records via the Nemours app patient portal at no charge. Complete the Authorization to Access (PDF) form.

Please note, records from another facility contained within the requested records may be released.

You may create a login for the Nemours app, a secure, confidential and easy-to-use patient portal that gives patients and families 24-hour access to selected parts of their medical records. This free program is designed to help patients and families easily manage and receive important health information. To get started or for more information go to Nemours.org/NemoursApp, or call (877) 696-3668, Monday through Friday from 8 a.m. to 5 p.m EST.

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, email or fax) an Authorization for Release Form (PDF). Identify who you’re authorizing under the “Disclose Medical Record To” section of the form.

• Authorization to Release Form (PDF) English | Spanish

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, email 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, email 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, email 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.