At Broward Outpatient Medical Center, we are familiar with the insurance and legal aspects of claims. To make the process as efficient as possible and still maintain compliance with HIPAA, we have fully digitized the patient information format and request.

HIPAA Medical Records Release: If you are not the patient - you are an attorney, insurance representative, etc., and requesting patient information for the first time, it it is important that you file a HIPAA Release Form, or we will not release the patient's files to you on request. For a copy of an executable HIPAA Medical Records Release form, please click here: HIPAA Medical Records Release form. Please email the signed HIPAA release to Patientadvocateteam@Browardoutpatient.com

Patient Medical Records Request: Please fill out the form below and your request will be addressed within one (1) business day. If there are issues or concerns with the request, you will be contacted by the information provided.

Patient Information

Patient's Name

First Name

Last Name

Patient's Date Of Birth

YYYY

Requester Information

If you are the patient, you may ignore this section. It is exclusively for non-patient information requests.

Who are you

Have you submitted your HIPAA records release form?

What is the purpose of your request

What is your name (if you are not the patient)

First Name

Last Name

What is the name of your company and your position

What is your phone number

(###)

###

####

What is your fax number

(###)

###

####

What is your email address

Records Requested

Please select the records you are requesting

New Patient Form

Medical File

Doctor Notes

Billing & Payment Information

Complete Patient File

Information Destination

Please enter the fax number or email address you wish the records to be sent to

Confirmation

By typing your name, you are confirming your request for the records is for the legitimate purpose stated above, that you are the person identified above, under penalty of perjury.

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Mailing Address

PO BOX 50010
Lighthouse Point, FL 33074

Phone

754-205-0682

See what our patients are saying about us!

Testimonials

Joseph M.

I can't say enough about how good you all are. You can build a state of the art medical facility anywhere, but the people working in this building cannot be found just anywhere. Thank you for making us feel comfortable during a scary time!

Javion M.

I went in to get my left knee examined by the doctor. Instead of recommending surgery, he opted to do a non-surgical alternative treatment. My knee feels much better than it did before. I highly recommend Broward Outpatient Medical Center.

Susan M.

BOMC truly is convenient! I called ahead five minutes before entering the office and was taken care of in no time at all! The wait time was short and I was able to get back to my daily routine quickly.

Donna S.

Frank M.

Broward Outpatient Medical Center is one of the finest medical care facilities I have ever had experience with in my life. I can see nothing to say but please keep up the great care. My level of confidence in medical treatment and care by the fine staff and doctors is infinite. Thank you for making me feel so welcome and comfortable.

Jane S.

Dr. Propper is an extremely intelligent, professional, kind, and conscientious physician. He explained the procedure very carefully before, during and after and answered all of my questions. The procedure, Stem Cells on my meniscus tear near my left knee, is already practically healed-even after only 5 days! I’m back at the gym already!

Laurie C.

The office staff were so happy, helpful, and friendly! The nurses were extremely friendly and sympathetic. The doctor was fantastic!!! He did an amazing job taking care of me and talked to me the entire time. He was very personable. I have already shared my positive experience with several friends and highly recommended the office. Thanks to all who work at Broward Outpatient Medical Center. They helped turn my painful situation into a pleasant experience and really cared. I love that I was able to receive that level of care! I truly can't say enough good things about my experience and I will definitely return!!

Linda D.

My initial reaction to my meeting with Dr. Propper is that I LIKED HIM. He told me he could help me. I went to 2 other doctors who said there was no hope and no surgery. One told me PRP would not work. After one month after the procedure I am OUT of the boot and walking and will continue to get stronger. I have improved upwards of 40% on the Achilles and 30% on the wrist. I am walking and using my wrist. Thank you Dr. Propper!

Patient Information Request

Mailing Address

Phone

See what our patients are saying about us!