Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Dothan Specialty Clinic PC. Before sending anything sensitive, confirm the number and receiving department directly with Dothan Specialty Clinic PC, and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
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Dothan Specialty Clinic PC fax number
(334) 712-4280
Wrong or outdated? Report this number
Used for: Medical records release / authorization for disclosure of protected health information
Fax destination details
- Purpose
- Medical records release / authorization for disclosure of protected health information
- Form
- PHI release authorization — Patient Authorization for Use and/or Disclosure of Protected Health Information
- Address
- 4300 West Main Street, Suite 102, Dothan, AL 36305
- Voice phone
- 334-793-9564
- 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 information, describe the health information to be released or obtained, identify the recipient or facility, and specify an expiration date. Sign and date; the form may be faxed to the clinic's release fax number.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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