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Adirondack Radiology Associates, PC fax number

(518) 615-0390

North Country

Used for: Medical records release and PHI requests to obtain imaging, reports, or laboratory results from the Adirondack Radiology North Country facility.

Fax destination details

Department
North Country
Purpose
Medical records release and PHI requests to obtain imaging, reports, or laboratory results from the Adirondack Radiology North Country facility.
Form
Outside Image Release (PHI Release Authorization) — Release to Obtain Protected Health Information from Outside Facility
Address
170 Carey Road, Queensbury, NY 12804
Voice phone
518-793-1000

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.

Complete patient details, authorize the release of PHI (radiology images, written reports, laboratory reports) to Adirondack Radiology North Country; sign and date the form; provide the outside facility information.

Official form instructions are published as a downloadable file on the organization's website.

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