Medical Records & Release of Information

Santana Mental Health Services respects patient privacy and maintains medical records in accordance with applicable federal and state privacy laws. Patients may request access to their own health care records, and Santana Mental Health Services may charge a reasonable fee for copying and mailing records as permitted by law. Medical records may include information related to evaluation, diagnosis, treatment, billing, insurance, medication history, and other health care information used to support patient care.

How to Request Medical Records

To request records, patients or authorized representatives may submit a written request or valid HIPAA authorization to Santana Mental Health Services. Requests should include: Patient full name Date of birth Contact information Specific records being requested Date range of records requested Where records should be sent Patient or authorized representative signature Any required authorization or release form Santana Mental Health Services may release health information when a patient or authorized representative submits a valid written request or HIPAA authorization, or when disclosure is otherwise required or permitted by law, court order, subpoena, regulation, or legal process.

Authorizing Release to Another Person or Organization

If you want Santana Mental Health Services to send records to another person, provider, school, attorney, insurer, or organization, you may need to complete a release of information form. A release form may ask you to identify: Who is authorized to receive the information What information may be released The purpose of the release When the authorization expires Whether the authorization may be revoked Disclosures that go beyond treatment, payment, or health care operations may require a separate patient authorization.

Mental Health and Substance Use Records

Mental health records may have additional confidentiality protections under Florida law in addition to HIPAA. Substance use disorder treatment records may have additional protections under 42 CFR Part 2 and may require separate written consent before they can be used or disclosed, except as otherwise permitted by law.

Revoking an Authorization

Patients may revoke a HIPAA authorization by written notice. Revocation applies prospectively and does not undo actions already taken in reliance on the authorization.

Contact for Records Requests

Santana Mental Health Services LLC
5901 SW 74th St, Suite 211
South Miami, FL 33143
Phone: 786.228.6892
Fax: 786.414.3622
Email: admin@santanamhs.com

This page is provided for general patient information and does not replace Santana Mental Health Services’ full intake forms, consent forms, privacy notices, financial agreements, or applicable law. If there is any conflict between this page and the signed patient forms, the signed forms and applicable law control. Patients may contact Santana Mental Health Services with questions.