Steps to request your medical history from your treatment at Monte Nido & Affiliates.

  • 1. Please complete the Consent to Release Medical Record Information authorization form making sure the following required fields are filled in properly to process the request:

    • Patient’s full name (include maiden name, if applicable)
    • Address
    • Phone number
    • Email address
    • Date of birth
    • Facility name where treatment was rendered

    Identify the method for us to share the requested medical records by clearly indicating the mailing address, fax number, email address

  • 2. Sign and date the completed authorization form.

  • 3. Fax your request with all required information included to 781-647-0215

    or mail all required information included to:

    Monte Nido & Affiliates
    Medical Records
    6100 SW 76th Street
    Miami, Florida 33143

Important reminders.

Please direct any questions regarding medical records to:

Medical records requests may take up to 30 days for processing.

Do not email medical records requests. We cannot guarantee security of all Personally Identifiable Information included in the form if submitted via e-mail.

For Audit-related questions, please call 781-647-6782 or fax 781-647-0215. 

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