Calhoun Liberty Hospital is proud to partner with Verisma, a trusted provider of secure health information services, to streamline and safeguard the process of requesting medical records.
Patients have immediate access to their medical records via our secure patient portal – My Care Corner.
Website: My Care Corner
How to Request Your Medical records in Person
You will be asked to verify your identity by showing a valid government issued ID.
If the patient is requesting someone else pick up their medical information, we have to have:
1. Written permission from the patient
2. A copy of the patient’s valid government ID
3. A valid government issued ID must be presented by the patient’s representative.
If you are a legal representative of a patient (Parent, custodial parent of a minor, court appointed guardian, etc.), you may be required to submit supporting documentation to complete the request.
How to Request Your Medical Records Online
You can conveniently request your Calhoun Liberty Hospital medical records online. Please select the appropriate form below:
- ONLINE Patient Records Request (English)
- Solicitud de registros de pacientes (Español)
- DOWNLOAD Patient Record Request Form for printing
To verify your identity and authorization, you must upload a clear photo of a valid government-issued ID (such as a driver’s license, state ID, or military ID). You can easily capture this image using a webcam or smartphone.
If you are a legal representative (e.g., custodial parent of a minor, court-appointed guardian, medical power of attorney), you may be required to submit additional legal documentation.
Processing Time: Most requests are completed within 24 to 48 hours of submission.
Need Help? Contact Verisma Customer Service
- Email: customerservice@verisma.com
- Phone: 866-837-5550
Phone: 866-390-7404 – For the status of a request (24 hours)
You will need:
1. An invoice number
OR
1. Patients DOB
2. First Name
3. Last Name
Urgent Requests for Physicians (Same-Day)
If your healthcare provider requires immediate access to your records for continuity of care, they may request them directly:
- The physician’s office must fax a request on official letterhead along with a signed authorization to:
- Fax: 1-800-308-8066 (Calhoun Liberty Hospital Health Information Management Department)
For Insurance, Legal, or Disability Requests
Non-patient third parties (e.g., insurance companies, attorneys, disability determination services) should submit medical record requests via mail to:
Mailing Address:
Calhoun Liberty Hospital Association, Inc.
ATTN: HIM Department
16257 SR – 71 S
Blountstown, FL 32424
Hospital Contact Information
- Phone: 850-674-5411 Ext. 220
- Fax: 800-308-8066
- Hours: Monday – Friday, 8:00 AM – 4:30 PM CT