Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Acacia Family Medical Group before sending sensitive documents. FaxFlow is not affiliated with this organization.
Acacia Family Medical Group fax number
(831) 753-9717
Medical Records
Used for: Medical records release /PHI disclosure (Authorization for Release of Medical Records)
Fax destination details
- Department
- Medical Records
- Purpose
- Medical records release /PHI disclosure (Authorization for Release of Medical Records)
- Form
- PATIENT AUTHORIZATION FOR USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
- Address
- 400 East Romie Lane, Salinas, CA 93901; 8036 San Miguel Canyon Rd, Prunedale, CA 93907
- Voice phone
- 831-770-0123
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill patient/guardian name and contact; specify the records to be released, purpose (clinical care), expiration date, and signature; submit to Privacy Officer at 400 E. Romie Lane, Salinas, CA 93901.
Sources and verification
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