White-Wilson Medical Center

Obtaining Your Medical Records

To better serve our patients, and other requesters, White-Wilson Medical Center has partnered with BACTES Imaging to assist you with your request for a copy of your medical records.

Please fill out the Records Release Form below carefully, indicating where you would like the requested information delivered.

We value your privacy and want to ensure that the information is released properly. If a White-Wilson health care provider has referred you to another physician, a records release is not necessary.

Please note, that pursuant to HIPAA 45 CFR, 164.524, we reserve the right to charge a reasonable cost-based fee for producing and mailing copies of your medical record. If you would like your entire medical record, the rate will increase proportionally based on the cost. At not time will the cost-based fees exceed Florida law (Statute: 64B8-10.003).

After you submit your request, you'll receive a notification from BACTES regarding payment options. Once payment is received, records will be sent to you.

For Records being sent to another health care provider:
Please provide as much contact information for your other doctor as possible, including the address, phone and fax numbers. There is no charge for records delivered to another health care provider for ongoing treatment purposes.

  • Records Release Form
  • BACTES Fax Number: 850.863.6677
  • BACTES Customer Service Number:1-877-391-9890

BACTES is committed to providing the highest levels of quality, integrity and responsiveness. If you have any questions concerning the status of your request, please contact a BACTES Customer Care Representative.