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 It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Golden Valley Memorial Healthcare. Before sending anything sensitive, confirm the number and receiving department directly with Golden Valley Memorial Healthcare, 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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Golden Valley Memorial Healthcare fax number
(660) 885-5012
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Health Information Management (HIM)
Used for: Receiving medical records / health information requests (records release to/from Golden Valley Memorial Healthcare).
Fax destination details
- Department
- Health Information Management (HIM)
- Purpose
- Receiving medical records / health information requests (records release to/from Golden Valley Memorial Healthcare).
- Form
- ROI GV-1218 — Authorization to Use and/or Disclose Health Information
- Address
- 1600 N Second Street, Clinton, MO 64735
- Voice phone
- (660) 885-5511
- 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/guardian information, recipient/organization details, purpose of disclosure, dates, and sign; select whether records are to be released or obtained; note any restrictions; copy provided to patient; 90-day validity.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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