• Provide all requested information. 
• Be very specific about the information you need to have released. Write down dates, types of visits, and what parts of the record you need. 
• For X-ray films/images, please state on the form that you need X-ray films/images. 
• Sign and date the authorization using your full legal signature. 
• Mail the authorization form to: 
  Attention: HIM Medical Record Release 
  Driscoll Children’s Hospital 
  3533 S. Alameda St. 
  Corpus Christi, TX 78411 
• Or fax to (361) 808-2056

For questions, please contact a record release representative at (361) 694-5468. Please remember, if any information is missing or incomplete, we must return the form to you. This may delay the release of information.