Medical Records

Medical Records

We are committed to keeping your Protected Health Information (PHI) private, and we are required by law to respect your confidentiality. If you would like a copy of your medical records, please click here to electronically request them, you can submit by fax or email. Our offices are opened from 8:00 a.m. to 4:00 p.m., Monday through Friday if you have any questions.

Melbourne Regional Medical Center
Tel: 321-752-1561
Fax: 215-434-7295
Email: [email protected]

When you send a request to receive your medical records by fax or email, please be sure to provide a valid government-issued picture ID such as a driver’s license, identification card, passport, or comparison of signatures documented in the medical records.

If someone other than the patient is requesting to fax or email the records, that person needs to provide a government issued picture ID and an original signed authorization letter from the patient. There may be a charge for creating a copy of your records.

Click below to download the form:
English
Spanish

If you would like to check the status of a ROI Request please call (610) 994-7500.