Frequently Asked Questions Regarding
Health Care and Medical
How do I get medical information about an inmate?
After Release from Prison:
A completed DC4-711B, Consent and Authorization for Use and Disclosure Inspection and Release of Confidential Information, must be completed and signed by the inmate. By signing the DC4-711B, the inmate is authorizing release of medical, dental, or mental health information to a designated person/entity. By signing the release, the inmate(s) also understands that if the person or entity authorized to receive the health information is not a health-care provider, then the disclosed health information may no longer be protected from further disclosure by state or federal law.
This form can be completed by the inmate's family member, healthcare provider, attorney, or any individual that the inmate consents to receive PHC information.
The completed form must be mailed to:
Reception Medical Center
Attn: Medical Records
7765 S. CR 231
P.O. Box 628
Lake Butler, Fl 32054-0628
The inmate must contact the medical department at their facility and request/complete a Release of Information form.