Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Gerten Urogynecology before sending sensitive documents. FaxFlow is not affiliated with this organization.
Gerten Urogynecology fax number
(952) 920-0866
Records Release
Used for: Medical records release / records request
Fax destination details
- Department
- Records Release
- Purpose
- Medical records release / records request
- Form
- PATIENT RECORD RELEASE FORM — Patient Record Release Form
- Address
- 6565 France Ave S, Suite 300, Edina, MN 55435
- Voice phone
- (952) 924-8671
- 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 all sections (1-6) on GER-941_ROI; specify which records to release (office notes, radiology, lab, pathology, billing, etc.); indicate dates of service; state the reason for the request; provide recipient information; sign and date. Return via mail, drop off, or fax to the provided address. A fee may apply for releasing records. The form expires after one year from the date signed unless otherwise specified. Electronic signatures are not accepted.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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