Release of Information

Requesting Medical Records at Watson Clinic
Watson Clinic maintains your medical records electronically. That means your medical information will automatically follow you wherever you go within Watson Clinic, and your Clinic physicians will have instant and easy access to your medical history at the time of you appointment with them. You are encouraged to enroll and access your medical information through Watson Clinic's patient portal - MyChart. Access to medical records is protected by federal HIPAA regulations.

Requesting FMLA Paperwork at Watson Clinic
Click here for the forms needed to process Family and Medical Leave Act (FMLA) paperwork. In keeping with healthcare industry standards, there is a $25 fee for the completion and processing of the FMLA certification forms. This fee is due prior to processing the form by check or credit card payment. For credit card payments, please call 863-904-2628.
 
Requesting Records through Your MyChart Account
Log into your MyChart account. Under the Health icon, click on the Release of Information link and complete the Authorization to Disclose Protected Information form in its entirety and click Submit. Submitting this form through MyChart allows you to request and receive your medical records at no charge. Records requests will be processed during normal business hours, Monday through Friday.

You can now share your records with outside physicians through MyChart as well. Log into your MyChart account and under the Health icon and select Share My Record to generate a share code. The provider can enter the share code through this website to review your allergies, medications, health issues, immunizations, test results and past visit summaries. The physicians and providers will see only the information that has been released to your MyChart account. 

Paper copies of records may be released upon receipt of an Authorization to Disclose Protected Health Information form completed by the patient (if over 18 years of age) or parent/legal guardian. You may obtain the form by utilizing one the following methods:

The authorization form must be completed in its entirety or we will be unable to release your records. The completed form can either be mailed to the address at the top of the form or faxed to 863-904-2630. 

If you are requesting paper copies of your medical records for your personal use, the following fees apply as per Florida Rule: 64B8-10.003.

  • Price per page: $1.00 per page up to 25 pages and $0.25 per page for all pages thereafter.
  • Records requested for continuing care are sent directly to another medical provider or facility at no charge.

The Release of Information Services customer service desk is available from 8:30 am to 5:00 pm, Monday through Friday. If your records are needed for treatment or for an appointment within the next 48-72 hours, your physician can request them by fax when you arrive in his/her office for treatment (records can be faxed to the physician’s office at no charge to the patient).

 
*Please note that it is the patient's responsibility to provide us with any medical history information related to visits to physicians outside of Watson Clinic.

Revoking Health Information Exchange Consent
If you have previously opted in and consented to making your medical records accessible through the Health Information Exchange powered by Epic and you wish to revoke this consent, please read and complete the following form:
Please return the completed form to the Watson Clinic Privacy Office at 1600 Lakeland Hills Blvd. Lakeland, FL 33805. Phone: 863-680-7721. Fax: 863-616-2489