Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Cleveland Clinic before sending sensitive documents. FaxFlow is not affiliated with this organization.
Cleveland Clinic fax number
(216) 636-0991
MyChart Caregiver Area / Health Data Services
Used for: MyChart caregiver access request (proxy access) for a patient
Fax destination details
- Department
- MyChart Caregiver Area / Health Data Services
- Purpose
- MyChart caregiver access request (proxy access) for a patient
- Form
- Form A — MyChart Caregiver Request (Adult Proxy Form)
- Address
- Ab-7, 9500 Euclid Ave, Cleveland, OH 44195
- 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 Form A and transmit it to Cleveland Clinic via fax to 216-636-0991 or mail to Cleveland Clinic, Ab-7, 9500 Euclid Ave, Cleveland, OH 44195. The form collects requester and patient information, caregiver details, and the requested MyChart access level.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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