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).
Upon completion, you may fax, mail, or personally deliver your Authorization to the Health Information Management (HIM) Department at Gulf Coast 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 or military I.D.), and a telephone number. Per Florida statute, there is a charge of $1.00 per page for copies.
Please allow 1 - 2 business days for us to process your request.
Gulf Coast Medical Center
Health Information Management (HIM) Department
449 W. 23rd Street
Panama City, FL 32405
Tel: (805 747-7906
Fax: (850) 747-7128
8:00 a.m. – 4:30 p.m. Monday through Friday
For further information or assistance with the Authorization form, please call (850) 747-7906.