Request Medical Records for:
Shorepoint Health Punta Gorda
Shorepoint Health Venice
Shands Lake Shore
Medical records/health information for patients who have received care at these facilities. may be submitted utilizing this web page. Please see Questions About Medical Records for important information before submitting a request for records.
Requesting your medical records online is an easy and secure way to receive your information. All record requests will be processed by Datavant on behalf of these closed facilities. We recommend online requests for medical records/health information whenever possible. Simply click on the button below and follow the prompts.
For 3rd Parties requesters that utilize Datavant SmartRequest, you may use your SmartRequest login. The following are the site IDs associated with each location:
Shorepoint Punta Gorda: 73585
Shorepoint Health Venice: 73621
Shands Lake Shore: 73584
If you are not able to use the online request process, please download and complete one of the authorizations below. Third parties should include a request letter with their submission along with a completed patient authorization form. The completed authorization and, if applicable, request letter may be sent to: RemoteROIServices@datavant.com or faxed to 907-313-4405.
Patient Request Form - English
Patient Request Form - Español
Third Party Request Form - English
Third Party Request Form - Español
For submitted requests follow-up, please call: 1-800-367-1500 or email RemoteROIServices@datavant.com.
Questions About Medical Records
Who can request a patient's medical records?
Authorizations must be signed by the patient or the patient's legal representative. If the patient is a minor (under age 18), authorization must be signed by a custodial parent or a legally appointed guardian. Proof of guardianship is required.
What if the patient is unable to sign the authorization?
If the patient is unable to sign by reason of physical or mental disability, authorization may signed by the next-of-kin or legally appointed guardian. Proof of guardianship is required, and must indicate the patient's disability.
How can I receive records for someone who is deceased?
Authorization must be signed by the personal representative of the estate or next-of-kin. If the patient did not expire at the facility, proof of death is required. Additionally, appointment as the personal representative of the estate or status as next-of-kin must be verified.
What types of documentation are needed if I am requesting records for someone else?
If you hold Power of Attorney (POA), are a Healthcare Surrogate or Healthcare Proxy, the related legal forms and court orders must be provided. This may result in additional review and processing times.
Do medical request authorizations expire?
Yes. Authorizations will expire on the date/time or event specified on the release form. A new release form will be
required if an older release form does not support the new request for records.
Do medical records include billing information?
No. The Medical Records Department does not have access to billing records or information.
Will there be a charge for copies of my medical records?
There may be a charge for copies of medical records for yourself or request directed to a third party (excluding continuity of care request). These charges would be in accordance with HIPAA reasonable cost and/or your state law. Please call 1-800-367-1500 for questions concerning potential costs