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Broadway OB/GYN fax number

(401) 421-8792

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Medical Records

Used for: Medical records release

Fax destination details

Department
Medical Records
Purpose
Medical records release
Form
Medical Records Release Form — Medical Record Release
Address
695 Eddy Street, Providence, RI 02903
Voice phone
401-272-1550

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 patient name, date of birth, and contact information; specify the records to release (All Records or specific records), purpose, and recipient; sign and date. Include the recipient's details and any required authorization. Fees may apply; processing can take several weeks (the provided form lists the steps and submission details).

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

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