Release of Information Form

If you are a former patient of Wekiva Springs Center, please print and complete the Release of Information and fax or mail, with a copy of your driver’s license or other Identification card.

Mail release to:

Wekiva Springs Center
Attention: Medical Records
3947 Salisbury Road
Jacksonville Florida 32216
or
Fax: 904 899 8752

Records are not processed until the patient is discharged from the facility.

Download Release of Information Form 

Are you or a loved one seeking care?
Please use this form for medical inquiries only. For any general questions, please call us at 904-296-3533.
Contact Us
Wekiva Springs Center - 3947 Salisbury Rd. Jacksonville, FL 32216
  • +1 (866) 234 - 6847
  • +1 (904) 296 - 3533