Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with CVS Health Privacy Office before sending sensitive documents. FaxFlow is not affiliated with this organization.

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CVS Health Privacy Office fax number

(401) 652-1593

Privacy Office

Used for: PHI disclosure requests and patient prescription record releases under HIPAA

Fax destination details

Department
Privacy Office
Purpose
PHI disclosure requests and patient prescription record releases under HIPAA
Form
Authorization for Disclosure of Protected Health Information (PHI) — CVS Pharmacy Disclosure Authorization Form
Address
1 CVS Drive, Woonsocket, RI 02895
Voice phone
1-833-533-0768

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, address; specify recipient; sign and date; fax completed form to 401-652-1593 to request PHI disclosures.

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

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