Medical Records
Memorial's Health Information Management department oversees the management of all medical records and release of information for care provided to patients at all locations across the Memorial Health System.
Hours
| Monday – Friday | 8:00AM – 4:30PM |
Contact Us
In-Person
Health Information Management Dept.
Memorial Hospital
1520 Broad Ave.
Gulfport, MS 39501
By Mail
Health Information Management Dept.
Memorial Hospital
P.O. Box 1810
Gulfport, MS 39502-1810
Coming Soon!
Convenient options coming soon for provider requests, legal requests and business office inquiries!
Request to Access Health Information
Memorial Hospital now has two options to request copies of your Medical Records.
A patient wishing to request access to his/her own private health record can download and complete the following forms.
- Option 1 – Medical Records Request Portal
- Option 2 – In person/email
Option 1:
Our new and most efficient way of requesting medical records electronically is to click REQUEST MEDICAL RECORDS and it will take you directly to the Request Medical Records Page.
- Please have a copy of Driver’s License or other government issued photo ID.
- Once processed, you will receive your records via email.
Option 2:
Should you want to request and pick up your medical records on site:
- You may complete this form by clicking the link below or can fill it out at our office in the MASS building.
- Use this option if a third party (a family member, insurance company, an attorney, etc.) is requesting the medical records
- If you choose to complete in advance, please download this form.
- Email completed and signed form to himroi@mhg.com. A signature is required for processing.
Acceptable Photo IDs
- Driver’s License
- Employment ID
- State Issued ID
- Current School ID
- Military ID
- VA ID
- Valid, Current Passport
Other Necessary Documents as Applicable
- Power of Attorney for Healthcare
- Legal Guardianship Papers
- Court Documents Establishing Emancipation
- Divorce Decree
- Death Certificate
- Executor of Estate
Once fully completed and signed, scan/email, mail, fax or deliver to the Health Information Management Department (located inside the Memorial Administrative Support Services – MASS – Building).
Additional Important Information
- Persons over the age of 18 or under the age of 18 but considered an emancipated minor have the authority to release personal private health information on his/her own.
- If you prefer to pick up your information rather than have it mailed, please indicate this on your form before submission.
- If there is an urgent need for quick access or any other special handling information, please document on your form before submission.
- Depending of the nature of your request, fees for printed information or supplies may apply.
- Along with your request whether by mail, fax or on site, please provide one of the following forms of identification and necessary documents (if applicable) to validate the release of information:
In some cases, there may be a delay in processing requests due to record completeness at the time of the request.
Mississippi Certified Copies of Birth and Death Records
Memorial gathers information to begin the process of registering a birth or death event. To request certified copies of birth or death records, please visit the Mississippi State Department of Health‘s website. You may also contact MSDH:
By Mail
MS State Dept. of Health/Vital Records
P.O. Box 1700
Jackson, MS 39215-1700
By Phone
Recorded Instructions (601) 576-7450
Additional Assistance (601) 576-7981
In compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Mississippi Statute, the Health Information Management Department is fully committed to the protection of private health information as well as the provision of health information to facilitate the needs of the patient. Records are prepared based on requests submitted to the Health Information Management Department.