Health Information Management/Medical Records
HIM (formerly called the Medical Records Department) oversees the management of all medical records and release of information for care provided to patients at Memorial Hospital at Gulfport, Memorial Physician Clinics and Memorial Behavioral Health.
HIM DEPARTMENT HOURS
Monday-Friday 8:00 a.m. - 4:30 pm
Phone number: (228) 865-3172
Fax number: (228) 865-3557
Health Information Management Dept.
Memorial Hospital at Gulfport
PO Box 1810
Gulfport, MS 39502-1810
The HIM Department is fully committed to the protection of private health information as well as the provision of health information to facilitate patient care services. We release copies of patient records upon request, provided we receive a fully complete and valid authorization signed by the patient or legal representative that meets the requirements outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and MS State Statute. Persons over the age of 18 or under the age of 18 but considered an emancipated minor have the authority to release medical information on his/her own.
Download the Authorization for Release of Health Information
The Authorization for Release of Health Information may be printed via this link and mailed/faxed or you can personally visit the Health Information Management Department to complete an authorization form for records request. If you prefer to pick up record copies rather than have them mailed, please indicate this on your authorization form and include a daytime phone contact number. Depending upon the nature of the request, fees for record copies may apply. If there is an urgent need for quick access or any special handling information, please document this on the completed authorization form.
Upon request of records, 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:
ACCEPTABLE PHOTO ID's INCLUDE:
- Drivers 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
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
The hospital gathers information to begin the process of registering a birth or death event. To request certified copies of birth or death records you may follow the link to:
MS State Department of Health Site: www.msdh.ms.gov
MS State Dept. of Health/Vital Records
PO Box 1700
Jackson, MS 39215-1700
Recorded Instructions 601-576-7450
Additional Assistance 601-576-7981