How to Complete a Release of Information Form

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Active clients:

•    Must go to the most convenient outpatient service location (refer to locations above) with photo id, required documentation and sign a Release of Information within their medical record.

 

 

Inactive clients:

•   May go to the most convenient outpatient service location (refer to locations above) with photo id and sign a Release of Information.

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•   May download a copy of the Release of Information, have it notarized and mailed to Suncoast Center at 4024 Central Avenue, St. Petersburg, FL 33711.

 

 

Please Note:

•   No record will be released without a valid, signed Release of Information on file.

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​​​While we make every effort to process each request within 7 days, requests may take up to 30 days to process.