Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Brenner Children's Developmental and Behavioral Pediatrics before sending sensitive documents. FaxFlow is not affiliated with this organization.
Brenner Children's Developmental and Behavioral Pediatrics fax number
(336) 713-7842
Developmental and Behavioral Pediatrics
Used for: Medical records release / Authorization for Use or Disclosure of Protected Health Information (HIPAA authorization)
Fax destination details
- Department
- Developmental and Behavioral Pediatrics
- Purpose
- Medical records release / Authorization for Use or Disclosure of Protected Health Information (HIPAA authorization)
- Form
- HIPAA Authorization for Release of Protected Health Information — Authorization for Use or Disclosure of Protected Health Information (Release of Information)
- Address
- 3325 Silas Creek Parkway, Winston-Salem, NC 27103
- Voice phone
- 336-713-0678
- 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 name and date of birth, specify records to release, designate recipient, purpose, delivery method, and signature/date; fax to 336-713-7842; keep a copy for your records.
Sources and verification
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