To request your medical record from BayCare Alliant Hospital, you can download our printable Release of Information Form below. Please print and fill out the form, sign it and mail it to us at the address listed below. Please note: We must have your signature to release the records you request. To protect your confidentiality, all patients 18 years of age or older must sign the Release of Information Form. A parent or a legal guardian may sign for children under the age of 18. If you have any additional questions, please visit our FAQ page or call (727) 736-9867.

Download the Release of Information Form

If you wish to pick up your medical records, you may do so at our hospital. There is a nominal fee of $1 per page.
Hours of operation are Monday-Friday, 8 a.m. to 4:30 p.m. 

Our address:
BayCare Alliant Hospital
601 Main Street
Dunedin, FL 34698

To contact us by phone, please use the following numbers:
Medical Records (727) 736-9867
Fax:  (727) 736-9817
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