Florida Department of Elder Affairs Amendment Correction of Health Record Request Form
Form Template
Patients may discover incorrect information in their medical record(s) or find incorrect health care informations.
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Patients can use the Florida Department of Elder Affairs Amendment Correction of Health Record Request Form app to submit changes to the medical record. The app has applicants acknowledge that patients have the right to submit a Medical Record Amendment/Correction Form to be made a part of the medical record. This right does not permit applicants to alter or change the original record created by the health care provider or his/her staff. They may deny requests to amend or correct records. The app makes it easy to submit corrections.
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