If you are requesting medical records for yourself or a patient under your care, you must fill out an Authorization to Release Protected Health Information form.
Important Information Regarding Record Requests
Where to Return the Form
Once you have completed the form, please return it using one of the following options:
Deliver to any Asthma and Allergy Associates of Florida location during business hours.
Click here for office locations and hours
Family Allergy & Asthma
Attn: Medical Records
9800 Shelbyville Rd. #220
Louisville, KY 40223
Fax: 502.429.6157, Attn: Medical Records
This email address is strictly for medical record release forms, and any other emails will not be responded to. For other questions, please call us.
Authorization to Release Protected Health Information form – English
AUTORIZACIÓN PARA DIVULGAR INFORMACIÓN SANITARIA PROTEGIDA – Español
Healthcare Provider Requesting Documents
If another healthcare provider is requesting your medical records from our facility for continuing care, you DO NOT need to fill out a medical records request form. Please contact that healthcare provider and request that they fax their cover sheet with:
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