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Duke Health (Duke University Health System) fax number

(919) 620-5165

Health Information Management (HIM) - Release of Information

Used for: Authorization to Release PHI / Medical records release requests (ROI)

Fax destination details

Department
Health Information Management (HIM) - Release of Information
Purpose
Authorization to Release PHI / Medical records release requests (ROI)
Form
Authorization to Release PHI (Form M3132) — Authorization to Release PHI
Address
Duke Regional Hospital HIM, 3643 N Roxboro Rd, Durham, NC 27704; Duke University Hospital HIM, Box 3016, Durham, NC 27710; Duke Raleigh Hospital HIM, 3301 Executive Drive, MOB5, 2nd Floor, Raleigh, NC 27609; Duke Eye Center HIM, PO Box 101005, Durham, NC 27710
Voice phone
919-684-1700

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 the authorization, specify the recipient and PHI to be released, sign and date, and include an expiration date. Submit to the Duke Health ROI via fax to 919-620-5165 or mail to one of the listed HIM ROI addresses.

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

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