Patient Medical Records Request

Riverside Recovery of Tampa is committed to protecting patient confidentiality while making sure our clients get access to high-quality treatment options. We require patients who request copies of their medical records to complete and sign an authorization medical records release form.

All third party medical record requests must be made by the patient in order to receive medical records. Please submit a completed and signed form from the authorized patient.  

Download Form
Medical Records Release

Notice of Privacy Policy

At Riverside Recovery of Tampa, we believe your information is personal and confidential. Our Privacy Policy describes the privacy practices of Riverside Recovery of Tampa.

Print and complete the Authorization to Release Medical Records form. We require that you include a legible copy of a valid photo I.D (i.e driver’s license, state-issued I.D, or military I.D) in order to verify your authorization. 

Please email the completed form to [email protected] You may also either fax, mail, or deliver in person to obtain your records. 

Riverside Recovery of Tampa

Medical Records Request

4004 North Riverside Drive 

Tampa, Florida 33603

Fax: 813.441.7669

Phone: 813.296.8300

Please allow 3-5 business days for records to be made available.