Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Hampstead Hospital before sending sensitive documents. FaxFlow is not affiliated with this organization.
Hampstead Hospital fax number
(603) 329-9460
Health Information Management (HIM) Department
Used for: Submitting HIPAA health information requests and designation of personal representative forms to access medical records or share health information.
Fax destination details
- Department
- Health Information Management (HIM) Department
- Purpose
- Submitting HIPAA health information requests and designation of personal representative forms to access medical records or share health information.
- Form
- Designation of Personal Representative — Designation of Personal Representative Form
- Address
- 218 East Road, Hampstead, NH 03841
- Voice phone
- 603-329-5311
- 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 in patient details and designate a personal representative; return the form as instructed on the form (the document provides an email submission option to myDH@hitchcock.org and lists Hampstead Hospital HIM contact details for submission).
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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No public source link was saved with this record. Confirm the number directly with the organization before using it.