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Medical Record Request Form

Orlando Premier Psychiatry Patient Medical Record Request Form

All patient’s healthcare information is confidential and protected by State & Federal laws.

Orlando Premier Psychiatry require a completed, signed and dated Authorization for Release of Protected Health Information before healthcare records can be released to anyone, including the patient.

To ensure that Orlando Premier Psychiatry complies with federal privacy laws and regulations if anyone other than the patient, including spouses or family members are attempting to obtain medical records on the patient’s behalf, we require documentation granting legal authority or a sworn affidavit attesting to the representatives’ legal authority to obtain medical information on behalf of the patient.

How to Request a Copy of Your Medical Records

Given below is our process to request your medical Information.

Completed authorizations and any additional documentation that may be required can be sent to Orlando Premier Psychiatry via mail or email at the address listed below:

Orlando Premier Psychiatry
Attn: Medical Records
121 S Orange Ave Ste 920
Orlando, FL 32801

Email: info@orlandopremierpsychiatry

For Quick Help Feel Free to Reach OPP Team

If you have questions about this process, please feel free to email our Risk Management department at info@orlandopremierpsychiatry.com or call (407) 565-3546

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Don’t just take our word for it, hear from our clients

"Orlando Premier Psychiatry gave me the tools necessary to successfully maintain sobriety in the real world. I was a chronic relapser for years, even homeless. I was scared and had given up thinking I could get my life back together. I had tried getting well with countless other treatment centers and programs, but Orlando Premier Psychiatry really gave me that extra push that helped me get comfortable with being uncomfortable which was a huge part of what was holding me back from achieving long term sobriety. They also were the reason why I am still sober today, even through my dad’s passing."
Mike G.Patient
“Orlando Premier Psychiatry has been a wonderful place to go to for treatment. The staff is caring and helpful and the facilities are nice and spacious. The beds are extremely comfortable, and their pool is amazing. It’s nice only having to share a room with one other person. Groups throughout the day keep you grounded. When I had a couple of rough days the staff were there to support me. I would definitely recommend this program to anyone looking for help.”
Louie W.Patient
"Orlando Premier Psychiatry was a godsend for our family. Their extended program, based on not only counseling but also activities that help with learning to replace dependence on substances with new behaviors, provides the time and structure needed to rewire the brain and learn that life can be so much better with sobriety. The staff is caring and committed, and they work to provide life lessons that help with moving forward once the program is completed. We would highly recommend Orlando Premier Psychiatry for any individual or family searching for a program and people who can help someone willing to do the work necessary to begin on their path of sobriety."
Linda S.Patient

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Beginning the process of change can be difficult. Orlando Premier Psychiatry offers personalized, evidence-based psychiatric care and supportive guidance to help individuals navigate mental health and substance use–related challenges.

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