Patient Medical Release Forms

Use the forms below to authorize the transfer of medical records to or from Newsom Eye.

Send medical records to Newsom Eye

Download the medical release to Newsom Eye (PDF)

Request medical records from Newsom Eye

Download the medical release from Newsom Eye (PDF)

How do I submit my completed form?

You can upload completed medical records release forms through your MyPatientVisit patient portal account. For help, call (813) 908-2020.

For other paperwork, visit our patient forms page.