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Adirondack Radiology Associates, PC fax number
(518) 615-0390
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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
- 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.
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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