Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with HMT Dermatology Associates, Inc. before sending sensitive documents. FaxFlow is not affiliated with this organization.
HMT Dermatology Associates, Inc. fax number
(330) 662-0258
Dermatology
Used for: Medical records release / authorization for release of patient records
Fax destination details
- Department
- Dermatology
- Purpose
- Medical records release / authorization for release of patient records
- Form
- Authorization for the Release of Medical Records
- Address
- 5783 Wooster Pike, Medina, OH 44256
- Voice phone
- 330-725-0569
- 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 patient information; circle what to send (Entire Medical Record, Biopsy Reports, Lab Reports, etc.); specify recipient and contact details; sign; 90 days validity; $5 mailing fee; $20 transfer fee; submit via fax to 330-662-0258 or email hr@tcohio.com.
Official form instructions are published as a downloadable file on the organization's website.
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