Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Atrium Health before sending sensitive documents. FaxFlow is not affiliated with this organization.
Atrium Health fax number
(704) 446-6624
Leave of Absence Administration (LOAA)
Used for: Submitting medical and family leave requests (Medical LOA/FMLA) to LOAA via fax; includes completing the Medical LOA Request Form and physician certification.
Fax destination details
- Department
- Leave of Absence Administration (LOAA)
- Purpose
- Submitting medical and family leave requests (Medical LOA/FMLA) to LOAA via fax; includes completing the Medical LOA Request Form and physician certification.
- Form
- Medical LOA Request Form — Medical LOA Request Form
- Address
- 1000 Blythe Blvd, Charlotte, NC 28203
- Voice phone
- 1-704-355-2000
- 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 out the Request for Leave form; have your healthcare provider complete the Certification of Health Care Provider form; fax the documents to LOAA at 704-446-6624. For maternity or family care leaves, submit updates as needed and ensure the Fitness for Duty Return from Leave form is completed before returning to work.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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