Feb 18, 2022 · Thank you. Medical Records Request Form. In order for your other providers to provide your medical information to Gulfcoast Eye Care, please fill out the Medical Records Request Form. Palm Harbor 2650 Tampa Rd Palm Harbor, FL 34684. Pinellas Park 6036 Park Boulevard Pinellas Park, FL 33781 St. Petersburg 1515 9th Ave N St Petersburg, FL 33705..