Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Contemporary Obstetrics & Gynecology, PC before sending sensitive documents. FaxFlow is not affiliated with this organization.
Contemporary Obstetrics & Gynecology, PC fax number
(248) 656-4865
Obstetrics & Gynecology
Used for: Authorization to Release Medical Records / medical records requests
Fax destination details
- Department
- Obstetrics & Gynecology
- Purpose
- Authorization to Release Medical Records / medical records requests
- Form
- Authorization to Release Medical Records — Authorization to Release Medical Records
- Address
- 1135 W. University Dr, Ste 100, Rochester Hills, MI 48307
- Voice phone
- (248) 656-2022
- 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 patient details (name, date of birth, last 4 of SSN), indicate TO/FROM, recipient name and address, reason for transfer, sign and date, relationship to patient; fees apply; expires 90 days from signature; fax or mail to the office.
Official form instructions are published as a downloadable file on the organization's website.
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