Be sure to complete the highlighted portions of the Apalachee Authorization form.
Once completed, please send the form and a copy of your driver’s license and/or
photo ID by email, fax, or mail to:
Address: Disclosure Management
2634-J Capital Circle NE
Tallahassee, FL 32308
Fax: (850) 523-3432
Email: medicalr@apalacheecenter.org
Upon receipt, please allow 7-10 business days to review the request. Should you have any questions,
please call (850) 523-3333 ext. #5557