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Healthfirst fax number

(212) 801-3250

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Healthfirst Member Services

Used for: Health records request and authorization for sharing PHI

Fax destination details

Department
Healthfirst Member Services
Purpose
Health records request and authorization for sharing PHI
Form
PHI Authorization Form — Authorization to Release Protected Health Information (PHI) Form
Address
Healthfirst Member Services, P.O. Box 5165, New York, NY 10275-0308
Voice phone
1-844-347-5816

Before you send

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  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Complete and sign the form and return by mail, fax, or email to Healthfirst; specify the recipient and PHI types to share.

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Sources and verification

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