Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Franciscan Health before sending sensitive documents. FaxFlow is not affiliated with this organization.
Franciscan Health fax number
(219) 845-7139
Medical Records
Used for: Submitting requests for medical records and imaging; provider letterhead requests; release of information
Fax destination details
- Department
- Medical Records
- Purpose
- Submitting requests for medical records and imaging; provider letterhead requests; release of information
- Form
- Authorization form — Release of Information to Third Party Authorization Form
- Address
- 5454 Hohman Ave, Hammond, IN 46320
- Voice phone
- 219-932-2300
- 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 out the authorization form with patient identifying details, locations/records to be released, purpose, and expiration; sign and date; fax to 219-845-7139 or email MedicalRecords@FranciscanAlliance.org; fees may apply; expiration is typically 60 days unless otherwise specified
Review official form instructionsSources and verification
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