Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Essex Pediatrics PC before sending sensitive documents. FaxFlow is not affiliated with this organization.
Essex Pediatrics PC fax number
(802) 872-8021
Pediatrics
Used for: Medical records requests / authorization to disclose health information
Fax destination details
- Department
- Pediatrics
- Purpose
- Medical records requests / authorization to disclose health information
- Form
- Form D (Authorization to Disclose Health Information) — Authorization to Disclose Health Information
- Address
- 89 Main Street, Essex Junction, VT 05452
- Voice phone
- 802-879-6556
- 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 patient name and DOB, indicate whether sending or receiving information, specify recipient, sign and date; indicate the purpose and delivery method (fax). The form expires one year from the signing date unless revoked earlier.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.