Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Aviva Health before sending sensitive documents. FaxFlow is not affiliated with this organization.
Aviva Health fax number
(844) 870-1183
Privacy Office
Used for: Authorization to release protected healthcare information (PHI) to another healthcare provider or entity
Fax destination details
- Department
- Privacy Office
- Purpose
- Authorization to release protected healthcare information (PHI) to another healthcare provider or entity
- Form
- Authorization to Release Protected Healthcare Information — Authorization to Release Protected Healthcare Information
- Address
- 150 NE Kenneth Ford Drive, Roseburg, OR 97470
- Voice phone
- 541-672-9596
- 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 information and recipient details, specify which records to release (all records or select items), sign and date; if the patient is a minor, additional signatures may be required; the authorization remains valid for 12 months.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.